Remove Definition Remove EMR Remove STEMI
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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. Often with serial ECG changes — there will be 1 or 2 leads that "stand out" for being definitely different! 2021.21026.

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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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50 year old with acute chest pain, with ‘normal’ ECG and falling troponin

Dr. Smith's ECG Blog

Now let’s compare this with the existing paradigm to identify multiple preventable delays to reperfusion, which can be improved through the paradigm shift from STEMI to OMI. In the STEMI paradigm, patients with ischemic symptoms and ECGs that don’t meet STEMI criteria get serial ECGs.

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

STEMI MINOCA versus NSTEMI MINOCA STEMI occurs in the presence of transmural ischaemia due to transient or persistent complete occlusion of the infarct-related coronary artery. This has resulted in an under-representation of STEMI MINOCA patients in the literature. From Gue at al. Circulation. 2017;135(16):1490–3.

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A young patient with diminishing pain with a subtle but diagnostic ECG.

Dr. Smith's ECG Blog

Written by Emre Aslanger (Emre is our newest editor. mm STE even in the fourth universal definition of myocardial infarction. I believe that the nomenclature for the definition of MI should be based on the myocardium itself. Here are his publications.) Here, there is STE in lead V8 and V9.

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