The text highlights the limitations of relying solely on early electrocardiograms for diagnosing acute myocardial infarction, setting the stage for the use of serum transaminase determinations.
At the present time, when confronted with the problem of chest pain that is considered to be cardiac in origin, the physician regards the electrocardiogram as the final test in deciding if acute myocardial infarction has occurred. Too often, when the clinical diagnosis is suspected, the early electrocardiograms may be interpreted as normal or, if abnormal, may lack the features usually considered diagnostic of recent myocardial injury. When this happens, the unsuspecting physician, reassured by the negative electrocardiographic report, may fail to obtain serial tracings or he may even begin to look elsewhere for a diagnosis.¹In this way the patient may be denied adequate therapy, including complete rest and anticoagulants for his heart attack. In addition to the fact that early electrocardiograms may not show evidence of recent myocardial injury, certain additional difficulties arise in the electrocardiographic diagnosis of recent myocardial infarction. These include the fact that a
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Seymoure Krause (1956) studied this question.
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