False ST elevation in a modified 12-lead surface electrocardiogram

Precise recording of the standard 12-lead electrocardiogram (ECG) is technically time consuming. Placing limb leads on the torso has the major advantages of ease of use, increased speed of application, and decreased artifact. This modified ECG frequently substitutes for the standard 12-lead ECG in intensive care units to detect ischemia, although its implementation should be limited to interpreting arrhythmias. We describe a patient who was misdiagnosed with acute inferior myocardial infarction in a modified 12-lead ECG. To the best of our knowledge, this is the first case report regarding detection of false ST elevations in this setting. Always, a standard 12-lead ECG is recommended to evaluate any ST-T changes.