DIAGNOSTIC ERRORS DUE TO FIXED ACUTE ECG PATTERN AFTER MYOCARDIAL INFARCTION

Q waves and elevated S-T segments in the precordial leads of the electrocardiogram are commonly interpreted as indicating recent myocardial infarction. In the five cases here described they were so interpreted until evidence was obtained showing that the abnormalities had existed for periods ranging from three months to perhaps eight years. The patients were four men (aged 58, 67, 67, and 69) and one woman (aged 63). Aneurysm of the left ventricle was demonstrated in two of the five patients; in one the wall of the aneurysm was calcified. The erroneous diagnosis of recent infarction resulted in prolonged, unnecessary hospitalization in all cases and to the postponement of necessary surgery on three occasions. A single electrocardiogram is not sufficient to establish the diagnosis of recent myocardial infarction because the finding of Q waves and elevated S-T segments in the precordial leads after infarction sometimes persists indefinitely.