There is evidence available which demonstrates that ECG interpretation is not perfect. One study evaluating the pre-hospital recognition of ST elevation meeting criteria for thrombolysis showed that 51% did not have myocardial infarction as their final diagnosis [1].

A further study reported that correct differentiation of Benign Early Repolarisation (BER) from STEMI by a group of emergency physicians and cardiologists occurred in 81% and 90% of cases respectively [2,3].

The authors concluded that the cardiologists had significantly more years of experience and that this was why they were more accurate in making the correct diagnosis.

Learning bite

The ability to recognise BER from STEMI is not always straightforward and is in part related to clinician experience and clinical context.