UMEM Educational Pearls

Category: Cardiology

Title: Normal ECGs and AMI

Keywords: EKG, ECG, electrocardiography, acute myocardial infarction, prognosis (PubMed Search)

Posted: 9/29/2008 by Amal Mattu, MD (Updated: 8/17/2022)
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 A normal ECG should not be a huge source of relief when evaluating patients with possible or confirmed myocardial infarction. 8% of acute myocardial infarctions have a completely normal ECG at the time of presentation, and these patients have a 5.7% in-hospital mortality. Serial electrocardiography can certainly improve the yield of electrocardiography but does not rule out AMI with 100% accuracy.

Like most tests in medicine, the ECG is very useful at ruling in disease, but it is limited at ruling out disease.

[The Prognostic Value of a Normal or Non-specific Initial ECG in AMI. JAMA 2001.]