[Skip to Content]

Claim CME

Cardiology

Incorrect ECG Diagnoses?—Follow the Leads

To identify the key insights or developments described in this article

1 Credit CME

JAMA Internal Medicine

Published Online: March 6, 2023

Challenges in Clinical Electrocardiography

Article Information and Disclosures

Xingli Xin, MD¹;

Xuanxuan Li, MD²;

Qingjie Xin, MD³

Author Affiliations

¹Department of Cardiology, Huanghua Boai Hospital, Affiliate of Oriental College of Beijing University of Traditional Chinese Medicine, Huanghua, Hebei, China
²Department of Cardiology, Shijiazhuang Great Wall Hospital of Integrated Traditional Chinese and Western Medicine, Shijiazhuang, Hebei, China
³Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing, China

Read article on JAMA Network

Read Case Claim CME Answer

An individual in their early 70s presented to the emergency department with frequently recurring paroxysmal chest pain; each episode had a duration of 3 to 5 minutes. The patient had a medical history of hypertension and diabetes mellitus; vital signs were normal, except for elevated blood pressure (153/92 mm Hg). Chest auscultation revealed normal breath and heart sounds with no murmurs. The laboratory test results (hemogram, serum electrolytes, and troponin I and D-dimer levels) were all within normal limits. A chest radiograph showed no abnormality, and transthoracic echocardiography findings revealed normal left ventricular systolic function (ejection fraction, 60%). The electrocardiogram (ECG) tracing obtained on admission is shown in the Figure, A.

Claim CME

Please finish quiz first before checking answer.

An individual in their early 70s presented to the emergency department with frequently recurring paroxysmal chest pain; each episode had a duration of 3 to 5 minutes. The patient had a medical history of hypertension and diabetes mellitus; vital signs were normal, except for elevated blood pressure (153/92 mm Hg). Chest auscultation revealed normal breath and heart sounds with no murmurs. The laboratory test results (hemogram, serum electrolytes, and troponin I and D-dimer levels) were all within normal limits. A chest radiograph showed no abnormality, and transthoracic echocardiography findings revealed normal left ventricular systolic function (ejection fraction, 60%). The electrocardiogram (ECG) tracing obtained on admission is shown in the Figure, A.

Sign in to take quiz and track your certificates

Buy This Activity

Article Information

Corresponding Author: Qingjie Xin, MD, Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Rd, Chaoyang District, Beijing 100029, China (qingjiexingood@126.com).

Published Online: March 6, 2023. doi:10.1001/jamainternmed.2022.6944

Conflict of Interest Disclosures: None reported.

References

Chang Q , Xu Z , Liu R . Acute inferior wall myocardial infarction: what is the culprit artery? Circulation. 2021;144(23):1893-1895. doi:10.1161/CIRCULATIONAHA.121.057659 PubMed Google Scholar Crossref

Reiffel JA . ECG response: can you make the correct morphology, pathology, and rhythm diagnoses? Circulation. 2016;134(7):567-569. doi:10.1161/CIRCULATIONAHA.116.024356 PubMed Google Scholar Crossref

Zhai HL , He Y . Transient ST-segment elevation and QTc interval prolongation in a patient with persistent chest pain. JAMA Intern Med. 2021;181(12):1652-1653. doi:10.1001/jamainternmed.2021.6015 PubMed Google Scholar Crossref

Gregg RE , Zhou SH , Lindauer JM , Helfenbein ED , Giuliano KK . What is inside the electrocardiograph? J Electrocardiol. 2008;41(1):8-14. doi:10.1016/j.jelectrocard.2007.08.059 PubMed Google Scholar Crossref

Li C , Chang Q , Yu L , Liu R . An electrocardiographic artifact synchronized with the cardiac rhythm: a case report. Ann Intern Med. 2022;175(3):456-458. doi:10.7326/L21-0660 PubMed Google Scholar Crossref

Aslanger E . Maybe a dazzle but not puzzle. J Electrocardiol. 2010;43(6):682-684. doi:10.1016/j.jelectrocard.2010.04.010 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.