Watch what happens when you teach others how to find OMI

 Submitted by Dr. Caio Aguiar from Brazil, written by Pendell MeyersIt is immensely rewarding to receive these emails, like I received from Dr. Aguiar last week:" Last year I had a couple of lessons with you while on my internship.I finished my residency of Emergency Medicine and I ’m working at a great Emergency Department here in Brazil.Since then, I started looking for OMI EKG findings and not just STEMI.So, I ' m a follower of your blog, and I think I have a interesting case that I attended yesterday. "Case" Male, 43yo, come to ED with Epigastric Pain started 3 hours ago. Risk Factors: High Cholesterol. Vitals Signs: Normal. "Here is his initial ECG:PM Cardio standardized version below:What do you think?Here we have enlarged it for easier viewing, with limb leads on the right and precordial leads on the left:Dr. Aguiar diagnosed posterolateral OMI based on hyperacute T waves and slight STE in aVL, with its reciprocal STD and reciprocal negative hyperacute T waves in II, III, aVF, as well as the STD proportionally maximal right on the border of V4/V5.Here is PM Cardio ' s Queen of Hearts interpretation of the ECG. Confidently diagnoses OMI.He contacted the interventional cardiologist who was not convinced and cancelled the cath lab, stating that he wanted to see the first troponin result.Meyers note: In a case like this, when the cardiologist cannot see the posterior OMI, posterior leads may have shown STE, which might be more understandable for them. Remember: thes...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs