Open AccessRecognizing electrocardiographically subtle occlusion myocardial infarction and differentiating it from mimics: Ten steps to or away from cath lab
Author(s) -
Emre Aslanger,
H. Pendell Meyers,
Stephen W. Smith
Publication year - 2021
Publication title -
turk kardiyoloji dernegi arsivi-archives of the turkish society of cardiology
Language(s) - English
Resource type - Journals
eISSN - 1308-4488
DOI - 10.5543/tkda.2021.21026
Subject(s) - myocardial infarction , cardiology , medicine , coronary occlusion , occlusion , cath lab , conventional pci
It is increasingly evident that the ST-segment elevation (STE) myocardial infarction (MI)/non-STEMI paradigm that equates STEMI with acute coronary occlusion (ACO) is deceptive. This unfortunate paradigm, adhered to by the current guidelines, misses at least one-fourth of the ACOs, and unnecessarily over-triages a similar fraction of the patients to the catheterization laboratory. Accordingly, we have been calling for a new paradigm, the occlusion/nonocclusion MI (OMI/NOMI). Although this new OMI/NOMI paradigm is not limited to an electrocardiogram (ECG), the ECG will remain the cornerstone of this new paradigm because of its speed, repeatability, noninvasive nature, wide availability, and high diagnostic power for OMI. This review provides a step-by-step approach to ECG for the diagnosis of OMI.