Inappropriate cath lab activation

Hello everybody,

Here is an interesting case in emergency medicine involving “inappropriate” activation of the cath lab.

A 68-year-old patient, chronic alcoholic with associated cirrhosis, presents with lower chest pain radiating to both shoulders, which began approximately 20 hours before admission.

No associated dyspnea, no palpitations and no syncope.

Attached is the patient's ECG on admission, scanned on PM Cardio.

No STEMI / STEMI equivalent detected by the Queen of hearts

The interventional cardiologist contacted by telephone suspected a myocardial infarction in the inferior territory.

Coronary angiography showed that the coronary arteries were healthy.

“No epicardial lesion”

What are your differential diagnoses ?

It is interesting to note that the following publication is often confirmed in my medical practice : Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs. AI (Queen of Hearts by PMcardio)

Do you think that PM cardio does a better job than cardiologists and emergency physicians when it comes to detecting occlusive myocardial infarctions ?

Please respond in the comments :)

Looking forward to hearing from you !

Frédéric Caruso, M.D