Dr. Smith's ECG Blog

JULY 31, 2020

Their OMI Manifesto details how use of standard STEMI criteria results in an unacceptable level of inaccuracy, in which an estimated 25-30% of acute coronary occlusions are missed! The finding of dynamic ST-T wave changes on serial tracings in association with a change in chest pain symptoms ( SEE My Comment in the July 21, 2020 post ).

STEMI 52

STEMI Coronary EMR ALS 52

Dr. Smith's ECG Blog

DECEMBER 13, 2023

I published, and Emre Aslanger externally validated, the 4-Variable formula for differentiating the ST Elevation of LAD OMI from Normal ST Elevation. link] == MY Comment , by K EN G RAUER, MD ( 12/11 /2023 ): == As per Dr. Smith — the KEY concept in today's case is proportionality. Now you can see the STE and Hyperacute T-wave better.

EMR 107

EMR Coronary OR STEMI 107

Dr. Smith's ECG Blog

JANUARY 1, 2024

This was contributed by Co-editor Emre Aslanger, an interventional cardiologist in Turkey. A recent angiogram report indicated a totally occluded left anterior descending artery (LAD) and right coronary artery (RCA), with 30-40% narrowings in the left circumflex artery (LCx).

Coronary 91

Coronary EMR STEMI Emergency Department 91

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

By Smith, peer-reviewed by Interventional Cardiologist Emre Aslanger Submitted by anonymous A 53 y.o. Compensatory enlargement was defined as being present when the total coronary arterial cross-sectional area at the stenotic site was greater than that at the proximal nonstenotic site. The pain radiated to both shoulders.

Coronary 110

Coronary ACS OR EMR 110

Dr. Smith's ECG Blog

APRIL 21, 2023

But STEMI criteria has poor sensitivity for acute coronary occlusion. Like the initial hemoglobin level in acute hemorrhage, the initial troponin in acute coronary occlusion can be falsely reassuring. In the STEMI paradigm, patients with ischemic symptoms and ECGs that don’t meet STEMI criteria get serial ECGs.

STEMI 52

STEMI Coronary EMR EMT 52