31 yrs old male with chest pain?
Next step?

Quiz post: two patients with chest pain. Do either, both, or neither have OMI?

hqmeded-ecg.blogspot.com/2024/05/quiz-p…

Pendell Meyers

45-year-old male with chest pain.
Ekg doesn’t meet STEMI criteria so no urgent cath .Day 3 angio ➡️LAD occlusion ✅
Let’s not calculate the mm,s of STE to diagnose occlusion—it’s an outdated practice.Embrace OMI paradigm!
Stephen W. Smith Sam Ghali, M.D. Dr.ShrooqHawati 🇸🇦| د.شروق حَـوَتي Basit_Masoodi

Chest pain: Are these really 'Nonspecific ST-T wave abnormalities', as the cardiologist interpretation states?

hqmeded-ecg.blogspot.com/2024/05/chest-…

Jesse McLaren

F51 CP since two hours. On the left ECG 1, not OMI according to QoH. On the right ECG after 2 hours, OMI. hSTropo t0 6, 48 t2h. Cath lab and hems activated. Wait and see for the outcome Robert Herman, MD Pendell Meyers Stephen W. Smith Nanashī 🫀 PMcardio App Ro

Chest pain

Dx ?

“Check out this intriguing EKG of a 36-year-old female who comes to the ED with retrosternal chest pain radiating to both arms.. Would you activate the cath lab immediately? What’s your take on culprit vessel ? #Cardiotwitter Stephen W. Smith Sam Ghali, M.D. Amal Mattu Dr Shariq Shamim

Great presentation by Pendell Meyers of Carolinas Medical Center Emergency Medicine on the #OMI paradigm at Grand Rounds today!

SLU Cardiology Fellowship + SLU Emergency Medicine Residency… #LivefromGrandBlvd

SLU Graduate Medical Education

#emergencymedicine
#cardiology

Learn more about #OMI from Pendell Meyers
Stephen W. Smith
the EMCrit Crew
Alexander Bracey

hqmeded-ecg.blogspot.com/2018/04/the-om…

emcrit.org/emcrit/emcrit-…

rebelem.com/omi-nomi-time-…

Authority bias at EHJ

I think this is an entirely inappropriate and embarrassing comment from a reviewer at European Heart Journal:

Reviewer 1: 'This is a perspective article by a group of (mostly) Emergency Medicine clinicians arguing that the STEMI/NSTEMI 'paradigm' is out

Handed this ECG from triage. What will you do?
Pendell Meyers

hqmeded-ecg.blogspot.com/2024/05/handed…

An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

hqmeded-ecg.blogspot.com/2024/05/an-und…

Great retrospective study: Queen of Hearts AI App for diagnosis of acute coronary occlusion beats cardiologists. Sensitivity 70% vs. 40%.

Two contrasting EKGs of a patient rushed in with chest pain who received a swift cocktail of aspirin, clopidogrel, and morphine from the EMTs. Upon arrival, his pain eased, prompting paramedics to ask: did aspirin/clopidogrel work their magic . What would you say? #cardiotwitter

Early repol or anterior OMI?

hqmeded-ecg.blogspot.com/2024/05/early-…

Pendell Meyers

Crushing Chest Pain and Can't see OMI on the ECG? Just give morphine, right?

hqmeded-ecg.blogspot.com/2024/05/crushi…

Willy Frick

Willy Frick Sam Ghali, M.D. Robert Herman, MD Nanashī 🫀 Stephen W. Smith Pendell Meyers Emerson Floyd Brooks Walsh Alain Vadeboncoeur MD Hussam Sahloul @EvanLin89890019 Dr Razi Arron Pearce Drparray Mohammad 🫀EcgOxford ECGs The struggle is real. This was an abrupt stent closure immediately following RCA PCI (TVP for CHB). Respective proceduralist initially saying “You can’t see ischemia through a Paced rhythm.”

Two patients with diffuse ST depression and reciprocal ST elevation in aVR: do either/both/neither have Occlusion MI?

hqmeded-ecg.blogspot.com/2024/05/two-pa…

Jesse McLaren

⏱️ HR: 3rd degree AV block, Junctional escape
⚡️Electrical: vary PR, normal QRS/QT
🧭Axis: normal
📈R-wave: normal
🔋Tall/small voltages: normal
💔ST/T: inferior hyperacute T, reciprocal TWI aVL, anterior STD
= inferoposterior STEMI(-)OMI
Cath: 99%RCA, AV block resolved

Why is this patient in shock?

hqmeded-ecg.blogspot.com/2024/05/why-is…