ACS AI Module: Understanding diagnostic results

PMcardio for Individuals reliably detects 49 ECG conditions, including infarctions, rhythms, arrhythmias, heart blocks, axis, measurements and others. The full list of supported diagnoses is available at https://www.powerfulmedical.com/pmcardio-supported-diagnoses/. 

Practically, the diagnostic results are grouped into two AI modules: the ACS AI Module and the Core AI Module. In this article, we'll only discuss the ACS AI Module. For more information about the Core AI Module, please read here. 

ACS AI Module

It's the primary PMcardio module that shows on top of all the other diagnoses, above the Core AI results. It takes into consideration the patient's clinical presentation, i.e., if the patient has ACS (acute coronary syndrome) symptoms.

1. If PMcardio finds patterns suggestive of an occlusive myocardial infarction on the ECG, the application will ask you the following question to confirm the patient's clinical presentation:

You will get a final diagnostic result depending on the answer to this question.

If you answer Yes i.e., the patient has ACS symptoms, you will get a red result confirming an acute occlusive myocardial infarction, i.e., STEMI or STEMI equivalent:

If you answer No i.e., it's not an ACS-suspect patient, PMcardio will not trigger the red result, but will show you the following one:

If you leave the question blank or answer Unknown, you will get this interim yellow-coded result:

It's always possible to add the patient's clinical presentation later by clicking the blueAdd clinical presentation button. We always recommend doing so to obtain the accurate final diagnostic result and recommendation.

2. If it's a case where PMcardio doesn't find any signs suggestive of an occlusive infarction on the ECG, you will see the result as shown below without any additional information:

ACS AI Explainability (Blue heat maps)

💡Only included in the Pro Plan

This advanced feature generates a heat map overlay for each ECG lead, highlighting the regions of diagnostic importance that guide the ACS AI model’s decision-making process. It is available for positive cases, i.e. ECGs where PMcardio ACS AI Module finds signs suggestive of occlusive myocardial infarction (STEMI or STEMI equivalents). 

In cases of acute myocardial occlusion, the heat map draws attention to characteristic patterns such as ST-segment elevations, depressions, or T-wave changes that are critical for diagnosis. These visual cues offer not only a diagnostic aid but also an educational resource to refine clinical judgment.

Example:

You can find more information on our blog.

Additional information

As mentioned, PMcardio's ACS AI Module does not rely purely on the millimeter STEMI criteria when diagnosing acute occlusions but also takes into consideration STEMI equivalents, such as:

You can learn more about the module's superior performance compared to the current standard of care on our website.

If you are interested in further details about its development and initial validation, please refer to this European Heart Journal DH Validation Paper.