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It is rare for an artefact to be the cause of ST-segment elevation, especially in asymptomatic patients. An important distinction between true ST segment elevation caused by myocardial infarction and an artefact is that the baseline elevation in an artefact may begin before or after the appearance of the QRS complex. When confronted with an abnormal ECG with suspicious waveform contours and possibly only one completely normal limb leads, the diagnosis of arterial pulse artefact should be considered. 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