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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. Take home messages: 1- In STEMI/NSTEMI paradigm you search for STE on ECG. He is an interventional cardiologist in Turkey. Here is the post-intervention angiogram and post-PCI ECG. Turk Kardiyol Dern Ars.

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

Dr. Smith's ECG Blog

Meyers, Weingart and Smith published their OMI Manifesto — in which they extensively document the critically important concept that management of acute MI by separation into a “STEMI” vs “non-STEMI” classification is an irreversibly flawed approach.

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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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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. Here is his ED ECG at triage: Obvious high lateral OMI that does not quite meet STEMI criteria. For more on MINOCA — See My Comment in the November 16, 2023 post in Dr. Smith's ECG Blog ). The pain radiated to both shoulders.

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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. Let's stretch out the QRS vertically so it is not so tiny: On upper left is the original. On the right are the precordial leads stretched vertically, so that the QRS is not tiny.

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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. As per Dr. Aslanger — a number of medical providers were initial confused by what initially appears as marked ST elevation with reciprocal ST depression, indicative of an acute STEMI. That was also my initial concern.

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