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Dynamic OMI ECG. Negative trops and negative angiogram does not rule out coronary ischemia or ACS.

Dr. Smith's ECG Blog

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.

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See OMI vs. STEMI philosophy in action

Dr. Smith's ECG Blog

by Emre Aslanger Dr. Aslanger is our newest editorial member. Dr. Aslanger is also the author of the DIFFOCULT study: Emre K. Smith , d and Muzaffer Değertekin a DIFOCCULT: DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardial infarction. He is an interventional cardiologist in Turkey.

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Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

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).

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Sometimes even ST Elevation meeting criteria is not enough to be convincing

Dr. Smith's ECG Blog

Written by Emre Aslanger. Emre is a new Editor of the Blog. You can find many examples on this blog attesting that. I am sure that it is not for the readers of this blog. This is also a clear ECG for the readers of this blog, but may be hard for someone who is not used to seeing non-mainstream ECGs.

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Proportionality is a major element in the ECG Diagnosis of OMI.

Dr. Smith's ECG Blog

I published, and Emre Aslanger externally validated, the 4-Variable formula for differentiating the ST Elevation of LAD OMI from Normal ST Elevation. Knowing the patient has a history of coronary disease could be relevant to today's case — as it should add to our suspicion of a new acute event.

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Our OMI Toolbox Application is out now !

Dr. Smith's ECG Blog

Furthermore, some ECGs may not meet the STEMI criteria but may still be diagnostic for acute coronary occlusion (ACO). Many researchers, including the editors of this blog, tried to develop such tools in the recent past and we have recommended their use in certain clinical scenarios in many posts on this blog.

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OMI-NOMI paradigm established as better than STEMI-NSTEMI with new article

Dr. Smith's ECG Blog

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 article by Aslanger, Smith et al that is featured above in today’s post has just been published.

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