This study assessed the effectiveness of automated ECG reporting in patients with acute chest pain of suspected cardiac origin being transported to hospital by ambulance in one region of Denmark. Prehospital 12 lead ECGs were transmitted to the attending cardiologist. If a diagnosis of ST Elevation Myocardial Infarction (STEMI) were made, the patient was taken to an interventional centre. 200 randomly selected ECGs collected by the University of Copenhagen, were made available for a pilot study. The ECG report from the LIFEPAK 12 and by the Glasgow program was compared with the hospital discharge diagnosis. The sensitivity and specificity for a report of STEMI was 73% and 93% for the LP12 and 78% and 94% for Glasgow. Corresponding data for the attending cardiologist was 81% and 92%. There was no significant difference in sensitivity or specificity between the cardiologist's decision and the automated report.