• Resuscitation · Mar 2005

    Comparative Study

    Body surface mapping versus the standard 12 lead ECG in the detection of myocardial infarction amongst emergency department patients: a Bayesian approach.

    • Simon D Carley, Michelle Jenkins, and Kevin Mackway Jones.
    • simon.carley@cmmc.nhs.uk
    • Resuscitation. 2005 Mar 1; 64 (3): 309-14.

    ObjectiveTo determine if body surface mapping (BSM) is better than the standard 12 lead ECG in the diagnosis of acute myocardial infarction amongst emergency department patients.SettingA University affiliated inner-city emergency department.ParticipantsPeople presenting to an emergency department with symptoms compatible with myocardial ischaemia/infarction.Main Outcome MeasuresMyocardial infarction as defined by either standard 12 lead ECG changes with associated cardiac marker rise, Troponin T >0.1 microg/ml at > 12 h or autopsy/surgical findings of fresh macroscopic infarction.ResultsBSM had an overall sensitivity of 47.1% versus 40% for the 12 lead ECG (P < 0.001). Specificity for the BSM was 85.6% versus 93.7% for the 12 lead ECG (P < 0.001). These findings were consistent for low/moderate and high risk subgroups. Bayesian analysis demonstrates that indiscriminate use of BSM would result in a clinically important overdiagnosis of myocardial infarction amongst emergency department patients.ConclusionsBSM has a higher sensitivity, but a lower specificity for the diagnosis of myocardial infarction.

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