Key result
Recognizing arterial pulse tapping artifact that spares one limb lead prevents ACS misdiagnosis.
Why the study?
Arterial pulse tapping artifact can cause pseudo-ischemic ST-T abnormalities on electrocardiogram, mimicking acute coronary syndrome.
Case Report (n=1)
Arterial pulse tapping artifact can mimic acute coronary syndrome on ECG, but can be recognized by nonphysiologic ST-T wave distortion sparing a single limb lead and confirmed by electrode repositioning.
May avert unnecessary angiography in select chest pain cases; leaves open the artifact's true prevalence and recognition strategies.
INTRODUCTION: Arterial pulse tapping artifact is a deceptive electrocardiographic artifact caused by mechanical movement of an electrode from arterial pulsation, which can produce pseudo-ischemic ST-T abnormalities. CASE PRESENTATION: An 88-year-old woman presented with substernal chest discomfort that was burning in quality and radiated to her back. Vital signs were stable. Physical examination was benign. DISCUSSION: The presence of bizarre, nonphysiologic ST-T wave distortion, which spares a single limb lead, allowed for prompt recognition of arterial pulse tapping artifact. Recognizing this pattern-and confirmation with electrode repositioning-prevented misdiagnosis of acute coronary syndrome and inappropriate invasive angiography.
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Nerkar et al. (2026) conducted a case report in Arterial pulse tapping artifact mimicking acute coronary syndrome (n=1). Electrode repositioning was evaluated on Recognition of arterial pulse tapping artifact. Prompt recognition of arterial pulse tapping artifact, characterized by bizarre ST-T wave distortion sparing a single limb lead, prevented misdiagnosis of acute coronary syndrome.
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