tag:blogger.com,1999:blog-549949223388475481.post5418298653695759016..comments2024-03-26T22:42:04.176-05:00Comments on Dr. Smith's ECG Blog: OMI Can be Diagnosed by "Pseudonormalization of ST Segments" Unknownnoreply@blogger.comBlogger5125tag:blogger.com,1999:blog-549949223388475481.post-70104677976528460092020-10-05T22:20:55.364-05:002020-10-05T22:20:55.364-05:00@ James — THANKS so much for the kind words. I can...@ James — THANKS so much for the kind words. I can imagine how difficult it must have been when your treatment was delayed (and you KNEW it, because you recognized the correct ECG findings). As to “reclassifying” the system of terminology for acute infarcts — Drs. Smith & Meyers are doing ALL they can to make this reality — as per our July 31, 2020 post referring to the OMI Manifesto (https://hqmeded-ecg.blogspot.com/2020/07/omi-nomi-paradigm-established-as-better.html ) — and our Sept. 3, 2020 post, in which Dr. Meyers presents the “short version” ( ~17 minutes) of his talk on the OMI Manifesto ( http://hqmeded-ecg.blogspot.com/2020/08/omi-manifesto-lecture-in-20-minutes-via.html ). THANKS again for your comment!ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-43408422560039176502020-10-05T20:34:39.827-05:002020-10-05T20:34:39.827-05:00This is a great post. I’m a recent LAD OMI survivo...This is a great post. I’m a recent LAD OMI survivor. The clinicians did not follow this example of continued delta troponins. This caused a huge delay and transfer. As a ECG wizard myself,I was aware of my clinical status despite a non classic STEMI tracing. As Marriott reclassified heartblocks the diagnosis of MI should be reconsidered. Thanks JamesJames Ahttps://www.blogger.com/profile/16062739734179943895noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-27277840871626958092018-04-21T07:19:19.444-05:002018-04-21T07:19:19.444-05:00Fantastic post everyoneFantastic post everyonePendellhttps://www.blogger.com/profile/01445330667624442976noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-36223111426102782812018-04-20T18:00:02.575-05:002018-04-20T18:00:02.575-05:00Thanks, Ken!Thanks, Ken!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-65397053445272407122018-04-20T17:55:35.634-05:002018-04-20T17:55:35.634-05:00Excellent case & discussion by Drs. Lai, Lee &...Excellent case & discussion by Drs. Lai, Lee & Smith! I would add to the Learning Points that there was also “pseudonormalization” of QRS amplitude in serial tracings here, due to loss and/or cancellation of QRS forces from evolving infarction. Two additional comments I would make: i) The ST segment coving with symmetric T wave inversion seen in leads V5,V6 for the first 2 tracings is not normal. In a patient with symptoms — this finding should suggest ischemia and/or possible acute injury — and ii) The mean frontal plane axis for the first 2 tracings compared to the prior ECG from 2 months earlier is dramatically different (ie, the isoelectric QRS in lead II from those first 2 tracings was all positive in the earlier ECG). As a result — CAUTION is needed in comparing ST-T wave changes from the current tracings compared to the earlier ECG! That said, I agree there are still enough differences between the 3 tracings to support the conclusions in this case. THANKS for presenting!ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.com