Quality Issues and Artefact
Incorrect Machine Interpretation
Many ECG machines include automated interpretation, but this is not at all reliable. Relying on machine interpretation has led to many errors including overdiganosis, underdiagnosis, treatment delays and even patient deaths. Until better algorithms are developed, you MUST learn to interpret the ECG by yourself.
Groups of Signs
Variations: Quality Issues and Artefact
- Standard Calibration
- Chest compression artefact
- Double speed 50 mm/sec
- Wandering baseline
- Nonspecific baseline artefact
- Electrical interference artefact
- LA/RA electrode reversal
- LA/LL electrode reversal
- RA/LL electrode reversal
- RA/RL electrode reversal
- LA/RL electrode reversal
- LA/LL + RA/RL electrode reversals
- High V1/V2 misplacement
- Electrode Detachment
- Incorrect Machine Interpretation
- Transcutaneous pacing artefact
- Fistula artifact
ECG Library: Incorrect Machine Interpretation (36)
This ECG is from a man in his 50s who presented with acute chest pain.
This ECG shows anterior ST elevation with hyperacute T waves. The cause was a 100% proximal LAD occlusion.
This ECG is from a middle aged male who presented with chest pain. He was pain free at the time of this initial ECG.
This ECG shows subtle inferior ST elevation with reciprocal change in aVL. The cause was a large inferior infarct.
This ECG is from a woman of unknown age who presented with a clotted dialysis shunt. The computer interpretation was 'Normal'.
This ECG shows peaked T waves and flattened ST segments caused by hyperkalemia.
This ECG is from a middle aged woman who presented with chest pain and dyspnoea that improved after nitrogylcerin. The computer interpretation was 'normal'.
This ECG shows subtle ST elevation in inferior leads with reciprocal changes in aVL. Troponins were positive. The computer misinterpreted the ECG as normal.
This ECG is from a man who presented with a malfunctioning ICD but no chest pain or dyspnoea.
This ECG shows large T waves out of proportion to the QRS but with a very concave upstroke. This was similar to the baseline ECG. There was no acute infarction.
Where did they come from?
These ECGs were collected from Free Open Access Medical Education (#FOAMed) blogs, with the permission of their authors. You can find out more about each ECG's source by clicking on it.
Why are they here?
This is an experiment in digital curation. The idea is to collect resources to increase awareness and accessibility. Over time, more ECGs in the collection will be tagged to make it easier to find them and reused in new interactive quizzes.
How can I use these ECGs?
You can use these ECGs for your own learning, teaching or research - as long as you abide by the terms of each ECG's copyright licence as stipulated by the original author.