Interesting Selections from the Literature

Acute Coronary Syndrome

Sgarbossa, E., et al. (1996).  Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. The New England Journal of Medicine. 334, 481-487.

Brandt, R., Hammill, C., & Higano, S. (1998). Electrocardiographic diagnosis of acute myocardial infarction during ventricular pacing. Circulation. 97, 2274-2275. doi: 10.1161/01.CIR.97.22.2274

Birnbaum, Y. and Drew, B. 2003. The electrocardiogram in ST elevation acute myocardial infarction: correlation with coronary anatomy and prognosis. Postgrad. Med. J. 2003;79;490-504.doi:10.1136/pmj.79.935.490

de Winter RJ, Verouden NJ, Wellens HJ et al. A new sign of proximal LAD occlusion. N Engl J Med 2008;359:2071-3

Smith, S. (2005). T/QRS ratio best distinguishes ventricular aneurysm from anterior myocardial infarction. American Journal of Emergency Medicine, 23(3), 279-287.

Smith SW, Khalil A, Henry TD, Rosas M, Chang RJ, Heller K, Scharrer E, Ghorashi M, Pearce LA. Electrocardiographic Differentiation of Early Repolarization From Subtle Anterior ST-Segment Elevation Myocardial Infarction. Ann Emerg Med. 2012 Jul;60(1):45-56.e2. Epub 2012 Apr 19. PMID: 22520989 [PubMed – in process]

Dodd KW. Aramburo L. Broberg E.  Smith SW.  For Diagnosis of Acute Anterior Myocardial Infarction Due to Left Anterior Descending Artery Occlusion in Left Bundle Branch Block, High ST/S Ratio Is More Accurate than Convex ST Segment Morphology (Abstract 583).  Academic Emergency Medicine 17(s1):S196; May 2010.

Dodd KW.  Aramburo L.  Henry TD.  Smith SW. Ratio of Discordant ST Segment Elevation or Depression to QRS Complex Amplitude is an Accurate Diagnostic Criterion of Acute Myocardial Infarction in the Presence of Left Bundle Branch Block (Abstract 551).  Circulation October 2008;118 (18 Supplement):S578.


Mieghem, C., Sabbe, M., & Knockaert, D. (2004). The clinical value of the ECG in noncardiac conditions. Chest. 125, 1561-1576. doi: 10.1378/chest.125.4.1561

Holstege, C., et al. (2006). ECG manifestations: The poisoned patient. Emerg Med Clin N Am, 24 (2006) 159–177. Free full text.

Harrigan, R., et al. (1999). ECG abnormalities in tricyclic antidepressant ingestion. American Journal of Emergency Medicine, (1999), July 17(4), 387 – 393.

Delk, C., et al. (2007). Electrocardiographic abnormalities associated with poisoning. American Journal of Emergency Medicine, (2007), 25, 672-687.

Williamson, K., et al. (2006). Electrocardiographic applications of lead aVR. American Journal of Emergency Medicine (2006), 24, 864-874.

D. Jacobson and V. Schrire. (1966). Giant T wave inversion. British Heart Journal. 28(6), 768-775. PMCID: PMC490091.

Schimpf, R., et al., (2005). Short QT syndrome. Cardiovascular Research. 67, 357-366. doi:10.1016/j.cardiores.2005.03.026

Bakker, A., et al. (2009). The lewis lead: Making recognition of P waves easy during wide QRS tachycardia. Circulation, (2009), 119; e592-e593. [Free Full Text] doi: 10.1161/CIRCULATIONAHA.109.852053

Lewis T.  (1931). Auricular fibrillation. Clinical Electrocardiography. 5th ed. London, UK: Shaw and Sons; 1931: 87–100.

Wide Complex Tachycardia

Hollowell, H. et al. (2005) Wide-complex tachycardia: beyond the traditional differential diagnosis of ventricular tachycardia vs supraventricular tachycardia with aberrant conduction. American Journal of Emergency Medicine, (2005), 23, 876 – 889.


Tijunelis, M. and Herbert, M. (2005). Myth: Intravenous amiodarone is safe in patients with atrial fibrillation and Wolff-Parkinson-White syndrome in the emergency department. Canadian Journal of Emergency Medicine. (4): No.4, p262. Retrieved from:

Milstein (1987) and Aruda (1998):Milstein S, Sharma AD, Guiraudon GM, and Klein GJ. An algorithm for the electrocardiographic localization of accessory pathways in the Wolff-Parkinson-White syndrome. Pacing Clin Electrophysiol 1987 May; 10(3 Pt 1) 555-63. pmid:2440006.

Arruda MS, McClelland JH, Wang X, Beckman KJ, Widman LE, Gonzalez MD, Nakagawa H, Lazzara R, and Jackman WM.Development and validation of an ECG algorithm for identifying accessory pathway ablation site in Wolff-Parkinson-White syndrome. J Cardiovasc Electrophysiol 1998 Jan; 9(1) 2-12.pmid:9475572.

Unusual Causes of ST-Elevation and the Electrocardiographic Mimicry of Coronary Occlusion

Wang, K., et al. (2003). ST-segment elevation in conditions other than acute myocardial infarction. N Engl J Med 2003;349:2128-35.

Aziz, T., and Pereira, L. (2004). Electrocardiographic changes simulating a myocardial infarction after cardiac transplantation. The Journal of Heart and Lung Transplantation. 2004 Nov;23(11):1301-3.

Bilazarian, S. (2009). Pseudoinfarction pattern on electrocardiogram after coronary artery bypass. Chest. 1990 vol. 98 no. 5 1271-1274. doi: 10.1378/chest.98.5.1271

Strizik, B., and Forman, R. (1999). New ECG changes associated with a tension pneumothorax: a case report. Chest. 1999;115;1742-1744. doi 10.1378/chest.115.6.1742

Samaras, P., et al. 2007. Infarction-like electrocardiographic changes due to a myocardial metastasis from a primary lung cancer. Circulation. 2007;115;e320-e321. doi: 10.1161/CIRCULATIONAHA.106.650762

Brearley Jr, W., et al. (2007). Pneumomediastinum mimicking acute ST-segment elevation myocardial infarction. International Journal of Cardiology. 117 (2007) e73 – e75. doi:10.1016/j.ijcard.2006.11.156

Lehmann, G., et al. (2000). ECG changes in a 25-year-old woman with hypocalcemia due to hypoparathyroidism. Chest. 2000;118;260-262. doi: 10.1378/chest.118.1.260 

Chang, H., et al. (2012). Cylindrical battery ingestion with electrocardiogram mimicking ST-segment elevation myocardial infarction. J Am Coll Cardiol. 2012;59(25):2387-2387. doi:10.1016/j.jacc.2011.11.073

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