Serial - more than just a repeating breakfast item

Dr. Mattu reminds us that one ECG begats another.  If something doesn't look or feel right, repeat the ECG.  He sites a paper documenting 11% MI's not seen on initial ECG in a study of over 41K pt's! (Check out link below)

Additional pearl:
aVL, V2 depression can be reciprocal changes for inferior MI.

Diagnostic Time Course, Treatment, and In-Hospital Outcomes for STEMI Patients Presenting with Non-Diagnostic Initial ECG: A Report from the AHA Mission: Lifeline Program
Robert F. Riley, MD, L. Kristin Newby, MD, MHS, Creighton W. Don, MD, MSE, PhD, Matthew T. Roe, MD, MHS, DaJuanicia N. Holmes, MS, Sanjay K. Gandhi, MD, Michael A. Kutcher, MD, and David M. Herrington, MD, MHS

Copa Cardiogram #55