ACS-OMI
Results:
Diffuse ST Elevation: DDx
Key Points ST-Segment Elevation (STE): It’s crucial to recognize that several conditions beyond STEMI can cause ST-segment elevation (STE) on an ECG. Identifying these differentials is vital to avoid misdiagnosis…
Isoelectric Segment of the ECG
Key Points The reference for ST-segment shift is the J point relative to an isoelectric baseline. The two candidates for that baseline are the TP segment and the PR segment….
Artifact vs STEMI: DDx
Key Points Not all ST elevation is ischemia. The most common mimics at the point of care are atrial activity riding on the ST segment, motion or lead artifact, early…
Ischemia & Infarction
Key Points: Why the ECG matters: Fastest way to detect acute occlusion and dynamic ischemia before troponin and often before classic symptoms. ACS is dynamic: Arteries occlude and reperfuse. Serial…
Right Ventricular STEMI: Criteria & Pitfalls
Key Points RV involvement accompanies up to ~40% of inferior STEMIs; isolated RV infarction is uncommon but high-impact when missed. Think RV MI when inferior STEMI is present and you…
Terminal QRS Distortion: OMI Pattern
Key Points What it is: In V2 or V3, there is no S wave (the R does not descend below the PQ baseline) and no J wave (no notch/slur at…
LV Aneurysm vs STEMI: DDx
Key Points Left Ventricular Aneurysm (LVA): Causes persistent ST elevation lasting more than 2 weeks post-MI, typically seen in the anterior leads but can also affect the inferior leads. Occurs…
STEMI (-) Occlusion MI: OMI Patterns
Key Points Traditional STEMI Criteria Alone Miss Acute Coronary Occlusion MI: Widely used but insufficiently sensitive or specific, many genuine occlusions (OMIs) do not meet strict STEMI criteria. Current Guidelines…
LV Aneurysm
Key Points Definition: LVA is a chronic complication of prior transmural MI, caused by scar tissue formation and paradoxical wall motion. Persistent ST Elevation: ST elevation lasting > 2 weeks…
Occlusion MI: STEMI Criteria & Beyond
Key Points A STAT ECG is the most critical first test in suspected acute coronary syndrome (ACS). It allows for early recognition of acute coronary occlusion myocardial infarction (OMI), a…
Pseudonormalization of T Waves
Key Points Definition: Pseudonormalization is the apparent normalization of previously inverted T waves, often signaling reocclusion of a coronary artery that had recently reperfused. Mechanism: During reperfusion, ischemic T wave…
STEMI vs Severe Hyperkalemia: DDx
Key Points The ECG Chameleon: Severe hyperkalemia can produce ST segment elevations, wide QRS complexes, and conduction delays that closely resemble STEMI or ventricular tachycardia. Early misinterpretation can lead to…
STEMI vs Wide QRS (BBBs & Paced Rhythms): DDx
Key Points Wide QRS & Repolarization Abnormalities: Bundle branch blocks (BBBs) and ventricular-paced rhythms (RV, LV, BiV) cause abnormal ventricular depolarization, leading to secondary ST segment and T wave changes—even…
Occlusion MI in Ventricular Paced Rhythms: STEMI Equivalent Pattern
Key Points 1. Paced Rhythms and Acute MI Detection: Ventricular paced rhythms significantly alter ST segment and T wave morphology, complicating acute myocardial infarction (MI) recognition. Accurate ECG interpretation in…
Occlusion MI in Left Bundle Branch Block: STEMI Equivalent Pattern
Key Points LBBB Does Not Exclude Acute Coronary Occlusion: LBBB alters ventricular activation, leading to expected secondary ST/T abnormalities. However, acute occlusion myocardial infarction (OMI) can and must still be…
Modified Sgarbossa Criteria: STEMI Equivalent Pattern
Key Points Wide QRS Rhythms Can Mask OMI: Left bundle branch block (LBBB) and right ventricular (RV)-paced rhythms alter ventricular depolarization, producing expected secondary ST/T changes. However, acute occlusion MI…
Appropriate Discordance
Key Points Definition: Appropriate discordance is a normal repolarization pattern in which the ST segment and T wave are directed opposite to the main QRS vector. It reflects expected changes…
Aslanger Pattern: OMI Pattern
Key Points: STEMI Diagnosis and Contiguous Leads: While current guidelines typically require ST elevation (STE) in at least two contiguous leads for the diagnosis of STEMI, this practice is not…
Precordial Swirl: OMI Pattern
Key Points Definition: The precordial swirl sign refers to a rotational pattern of ST-segment abnormalities across the precordial leads, suggesting a dynamic and evolving occlusion myocardial infarction (OMI). It is…
ST Elevation in aVR with Diffuse ST Segment Depression: OMI Pattern
Key Points Pattern: ST elevation in aVR (≥1 mm), often with ST elevation in V1 and widespread ST depression (≥1 mm in ≥6 leads). Mechanism: Reflects global subendocardial ischemia, often…
ECG Tags
- A-Z
- ACS-OMI
- Annual ECG Competition
- Approach
- Arrest
- Arrhythmia
- Artifact
- Attending
- AV Block
- aVL
- aVR
- Axis
- Board Review
- Bradyarrhythmia
- Chest Pain
- Clumped Beats
- Conduction
- Core
- Curriculum
- DDx
- Devices
- Documentation
- ECG Interpretation
- ECG Variant
- Education/Teaching
- Electrolytes
- Emergencies
- Emergent Cath Lab Activation
- EMS
- Guidelines
- Hub
- Hypercalcemia
- Hyperkalemia
- Hypermagnesemia
- Hypocalcemia
- Hypokalemia
- Hyponatremia
- Hypothermia
- Index
- Intervals
- Irregular
- Ischemia
- J Waves
- LBBB
- Lead Placement
- Metabolic
- Mimics
- Narrow QRS
- Occlusion MI
- OMI Pattern
- Osborn Waves
- P Wave
- Paced Rhythms
- Pacemaker/ICD
- Paramedics
- Pauses
- PE
- Pediatrics
- Pericardial
- Pericarditis
- PGY-1
- PGY-2
- PGY-3
- PGY-4
- Post-Cardiac Arrest
- Posterior MI
- PR
- Preexcitation
- Prolonged QT
- Pulmonary Embolism
- PVCs
- Q Wave
- QRS
- QT
- R Waves
- RAD
- RBBB
- Regular
- Reperfusion
- Rhythm
- S Waves
- Segments
- Seizure
- Serial ECGs
- Shock
- ST
- ST Elevation
- STEMI
- STEMI Equivalent
- Stroke
- Structural
- Students
- Syncope
- T Waves
- Tachyarrhythmia
- Tachycardia
- Tamponade
- Toxicology
- TP
- U Waves
- Unstable
- Ventricular Rhythms
- Ventricular Tachycardia
- Voltage
- Waveforms
- Wide QRS
© 2026 ECG Weekly. All rights reserved. | Terms of Use | Privacy Policy
Powered by the member(dev) platform
Loading...