False-positive ST elevations during exercise stress testing can occur due to errors in computer-synthesised averaging algorithms, highlighting the need for careful interpretation of automated ECG data.
ECG averaging errors may mimic ischemia on stress testing; leaves open algorithm reliability and need for manual verification studies.
A 56-year-old man with multiple risk factors undergoing evaluation for chest pain developed ST elevations in multiple leads during exercise stress test. These ST elevations were not classical of ischaemic pattern. The coronary angiogram showed normal coronaries. The false-positive ST elevation was due to an error in the computer-synthesised averaging algorithm.
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Srinivas et al. (2013) studied this question.
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