• J Electrocardiol · May 2012

    Prehospital 12-lead ST-segment monitoring improves the early diagnosis of acute coronary syndrome.

    • Jessica K Zègre Hemsey, Kathleen Dracup, Kirsten Fleischmann, Claire E Sommargren, and Barbara J Drew.
    • School of Nursing, University of California, San Francisco, CA, USA. Jessica.zegre@nursing.ucsf.edu
    • J Electrocardiol. 2012 May 1;45(3):266-71.

    Aims/MethodsWe studied 620 patients who activated "911" for chest pain symptoms to determine the sensitivity and specificity of 12-lead electrocardiogram (ECG) ST-segment monitoring in the prehospital period (PH ECG) for diagnosing acute coronary syndrome (ACS) and to assess whether the addition of PH ECG signs of ischemia/injury to the initial hospital 12-lead ECG obtained in the emergency department would improve the diagnosis of ACS.ResultsThe sensitivity and specificity of the PH ECG were 65.4% and 66.4%. There was a significant increase in sensitivity (79.9%) and decrease in specificity (61.2%) when considered in conjunction with the initial hospital ECG (P < .001). Those with PH ECG ischemia/injury were more than 2.5 times likely to have an ACS diagnosis than those who had no PH ECG ischemia/injury (P < .001).ConclusionsPrehospital ECG data obtained with 12-lead ST-segment monitoring provides diagnostic information about ACS above and beyond the initial hospital ECG.Copyright © 2012 Elsevier Inc. All rights reserved.

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