The electrocardiogram recorded at the initial consultation was compared with the final diagnosis in 211 consecutive suspected slight or sub-acute coronary attacks in 206 patients.In 77 (36%) of the 211 episodes, acute (or subacute) myocardial infarction was finally diagnosed. The initial E.C.G. showed a diagnostic pattern in only 19 (25%) of these 77 episodes; in 39 (50%) it was abnormal but not diagnostic of recent infarction; while in 19 (25%) the E.C.G. showed no abnormality classified under the Minnesota Code, though in 16 of these there were definite minor changes.In 61 (29%) of the 211 episodes acute myocardial infarction was excluded and an alternative diagnosis was made. The E.C.G. was strictly normal in only 23 (38%) of these 61 episodes; in 15 (25%) it showed minor abnormalities, and in 23 (38%) it was grossly abnormal.
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