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.

See also: Quality Issues and Artefact

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ECG Library (36)

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In the ECGquest archives, this ECG has been tagged with: - 12-Lead Incorrect Machine Interpretation Anterior ST elevation Hyperacute T waves Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
Acute Chest pain in a 50-something, and a “Normal” ECG

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.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Incorrect Machine Interpretation Delta wave Wide QRS Wolff Parkinson White syndrome Dr Smith's ECG Blog CC BY-NC
What do you think about this Left Bundle Branch Block?

This ECG is from a man with recurrent episodes of tachycardia.

This ECG shows short PR interval with delta waves due to Wolff Parkinson White syndrome.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Incorrect Machine Interpretation Inferior ST elevation Reciprocal ST depression Acute Inferior MI Dr Smith's ECG Blog CC BY-NC
Chest pain resolved, and a “Normal” ED ECG

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.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Incorrect Machine Interpretation Inverted P waves Narrow QRS Retrograde P waves Short PR Accelerated junctional rhythm Dr Smith's ECG Blog CC BY-NC
What is going on here?? (The computer called it “STEMI” and “Intraventricular Conduction Delay”!!)
In the ECGquest archives, this ECG has been tagged with: - Chronic kidney disease 12-Lead Incorrect Machine Interpretation Flat ST segment Peaked T waves Hyperkalemia Dr Smith's ECG Blog CC BY-NC
I saw this computer “normal” ECG in a stack of ECGs I was reading

This ECG is from a woman of unknown age who presented with a clotted dialysis shunt.

This ECG shows peaked T waves and flattened ST segments caused by hyperkalemia.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Incorrect Machine Interpretation Inferior ST elevation Reciprocal ST depression Acute Inferior MI Dr Smith's ECG Blog CC BY-NC
The computer calls this a “normal ECG”. We’ll just keep making this point.

This ECG is from a middle aged woman who presented with chest pain and dyspnoea that improved after nitrogylcerin.

This ECG shows subtle ST elevation in inferior leads with reciprocal changes in aVL. Troponins were positive. The computer misinterpreted the ECG as normal.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Incorrect Machine Interpretation Normal T waves Normal Dr Smith's ECG Blog CC BY-NC
Large T-waves and a Computer Interpretation of ***Acute MI***

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.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Incorrect Machine Interpretation Hyperacute T waves Acute Anterior MI Dr Smith's ECG Blog CC BY-NC
A Computer “Normal” ECG. What is the diagnosis?

This ECG is from a patient of unknown age who presented with chest pain.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Incorrect Machine Interpretation Inverted P waves Lead misplacement Dr Smith's ECG Blog CC BY-NC
Chest pain and T-wave inversion in lead V2

This ECG is from a healthy young man who presented with chest pain. This was the initial ECG.

In the ECGquest archives, this ECG has been tagged with: - Diarrhoea Seizure 12-Lead Incorrect Machine Interpretation Long QT Tall U waves Hypokalemia Dr Smith's ECG Blog CC BY-NC
A patient with a “seizure” and a completely “normal” ECG

This ECG is from a patient who presented with their first ever 'seizure' on a background of recent diarrhoea. QTc = 595 msec.