  Coronary artery disease(CAD) is the most common type of heart disease and the
leading cause of death worldwide[1]. A progressive state of this disease marked
by plaque rupture and clot formation in the coronary arteries, also known as an
acute coronary syndrome (ACS), is a condition of the heart associated with
sudden, reduced blood flow caused due to partial or full occlusion of coronary
vasculature that normally perfuses the myocardium and nerve bundles,
compromising the proper functioning of the heart. Often manifesting with pain
or tightness in the chest as the second most common cause of emergency
department visits in the United States, it is imperative to detect ACS at the
earliest. This is particularly relevant to diabetic patients at home, that may
not feel classic chest pain symptoms, and are susceptible to silent myocardial
injury. In this study, we developed the RCE- ECG-Detect algorithm, a machine
learning model to detect the morphological patterns in significant ST change
associated with myocardial ischemia. We developed the RCE- ECG-Detect using
data from the LTST database which has a sufficiently large sample set to train
a reliable model. We validated the predictive performance of the machine
learning model on a holdout test set collected using RCE's ECG wearable. Our
deep neural network model, equipped with convolution layers, achieves 90.31%
ROC-AUC, 89.34% sensitivity, 87.81% specificity.
