Stage of Illusion
Report:
Sinus rhythm 63/min
Normal trace
Comment:
This is a potentially dangerous situation: acute infarct pattern normalises in that ST segments are again isoelectric and the T wave have not yet turned. Below (Fig 54a) is the trace taken 3 hours previously; next (Fig 54b) is the one taken a day later.
The patient should never be sent home because of a normal ECG. The act of taking an ECG implies suspicion of infarction or ischæmia – neither can be excluded so easily. A reasonable course of action is either to sent the patient out without an ECG (because an alternative diagnosis is established) or get a (properly insured) Cardiologist to do the sending home with normal ECG. A trained mind is legally allowed to err.
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