Predictors of van der Ende et al for Failure to Diagnose a Myocardial Infarction on an Electrocardiogram

Patient selection: myocardial infarction

Outcome: failure to recognize on an electrocardiogram (ECG)

Predictors for an acute myocardial infarction going unrecognized on an ECG:

(1) age < 50 years

(2) female gender

(3) no or minor cardiovascular risk factors (absence of classical risk factors)

(4) diabetes mellitus (Table 2)

Other factors not included in the report:

(1) clinician with limited skill in reading an ECG

(2) subtle ECG changes

(3) failure to measure the serum troponin

(4) single ECG (no follow-up)

(5) unknown substance abuse (methamphetamine, cocaine)