Wednesday, July 22, 2020

Subtle ECG Findings of Left Anterior Descending Artery (LAD) Occlusion -- LAD Occlusion MI (OMI)


I just gave this Zoom lecture to U Mass on Subtle ECG Findings of Left Anterior Descending Artery (LAD) Occlusion -- LAD Occlusion MI (OMI)

Subtle ECG Findings of LAD Occlusion - Steve Smith from Stephen Smith on Vimeo.







12 comments:

  1. Can I translate your video to my local language (Vietnamese). I think many cardiologist in my country can have more knowledge about LAD OMI findings. Thank you very much, Dr.Smith.

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  2. Thank you for all your effort on a great talk! Maybe I am just seeing things. In 41:38 on the bottom picture in lead V3, can you explain why this is not a terminal QRS distortion? For me, it looks like the S wave is above the baseline. I know it probably isn't because we are using the 4-variable formula. Thanks!

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    Replies
    1. Good question. It just barely makes it as low as the PQ junction.

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  3. Great video, Dr Smith. I'd like to know if the four-variable formula can have QTc Fridericia/Framingham instead of Bazett, say in the setting of suspected MI with a HR outside 60–100 bpm.

    Thanks.

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    Replies
    1. The correction formula does make a difference. I suggest using Aslanger's change to the formula outlined at 40:29

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  4. Very helpful. Amazing as always!!!

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  5. I am a Paramedic and Paramedic instructor in Oklahoma City. I have been utilizing your blog as a virtual text book in my classroom for over one year now and I am seeing dividends increase all the time. I progressed from having ER physicians look at me like I am from Mars when I report an OMI from the ambulance, to frequent recognition by physicians who have become familiar with me. The movement is alive in Oklahoma City and I share the OMI vs. STEMI whenever possible to anyone who will lend an ear. Thank you for this lecture. It was exceptionally beneficial for me, as it will be for my many medic students to come.

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    1. THANK YOU Jeff so much for the kind words! Glad that Dr. Smith's ECG Blog has been so helpful to you! — :)

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  6. Thank you Dr. Smith for all what you are doing in order to improve our ECG reading skills so we can translate it to a better outcomes. I must say I have never heard about OMI until a came across with your blog and it is so helpful, so thanks again. I know that in this lecture you are focused on LAD occlusion but in those ECG you are showing there are more findings, aren´t there? for instance in 6:00 I can see STD in II, III and aVF and STE in aVL but you don't mention them, so I don't know whether I'm just seeing things that are wrong or you only focus on the changes related with LAD occlusion. Thanks.

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    Replies
    1. You are correct, but it is not the most clearly diagnostic part of the ECG.

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