STEMI-NSTEMI vs OMI-NOMI: A Paradigm Shift in ECG interpretation of MI
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- Опубліковано 30 лип 2024
- Many doctors are not aware that over the past few years, there has been a tectonic shift in the interpretation of ischaemic ECGs. So much so that the STEMI NSTEMI paradigm is already outdated and a new paradigm called OMI NOMI has come into play. And as a result, we will have to unlearn & relearn many aspects of ischaemic ECG interpretation.
In this video, I will also discuss the answers to the following questions.
- How to diagnose Acute Coronary Occlusion before the ST Elevation occurs on ECG?
- What is the OMI NOMI paradigm?
- How to identify subtle findings of ACS on ECGs?
If you find my video useful, please let me know in the comments - that will motivate me to create more videos. Also please like, share & subscribe to my UA-cam channel. And don't forget to click on the bell icon.
@PracticalECGCourses
Timestamp
00:00 Introduction
00:36 STEMI & NSTEMI - Concepts
02:48 Is the STEMI NSTEMI paradigm serving its primary purpose?
05:13 Why is the STEMI NSTEMI paradigm failing us?
08:03 OMI NOMI paradigm
12:33 How can I diagnose Acute Coronary Occlusion before the ST elevates?
13:11 ECG 1
17:19 Learning Points from ECG 1
18:49 ECG 2
19:12 Take home message
Hi, My name is Obaid. I am an Emergency Physician working in the UK. Teaching ECGs is a passion of mine and I have been doing it for over 8 years now. My area of special interest is in teaching the concepts behind ECGs that we see in daily practice and demonstrating how to use these simple concepts to attain expert level ECG interpretation skills.
I conduct online ECG teaching courses which are targeted at senior A&E trainees & Consultants. The teaching in these sessions is aimed at enabling expert level ECG interpretation skills appropriate for an ED setting. These courses should also be appropriate for any other specialty, especially acute specialities as well.
If you would like to be informed about my courses, please fill the form on this link: rb.gy/dmkyq
Checkout my website at:
www.practicalecgcourses.com/
My other videos include:
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Awesome teaching, thank you and thank you ❤❤❤❤❤
Thank you. Glad you found it useful.😊 Please share with your colleagues.
Dr Obaid, your ECG content is purely top shelf. Excellent work and please keep up the good work!
Thank you for your kind comments. Please do feel free to share with others.
Excellent
Thank you
Thank you Obaid!
That was great. Concise and so easy to understand! Always been a great fan of your teaching style. ECG being so intimidating you make it feel so easy to understand. Please keep up your great work !!! All the best !
Thank you. Much appreciated.
Nice Obaid..!! 👍👍
Thank you 😊
Well explained...
Thank you 😀
Excellent well explained ecg next level ❤
Thank you. Glad you liked it.
Hi folks,
I hope you found the video useful. If so, please share it with you collegues - I believe it will be useful across all grades of medical specialities.
If you would like more of such content, let me know.
If you would like to be informed about my ECG teaching, fill in your details here rb.gy/dmkyq
Send me your responses regarding the 2nd ECG in the video
It has many findings, but there is a "clincher" which will give you the final diagnosis.
All the best.
I am Favoring OMI
V3 has no j wave or S wave so ST elevation there unlikely BER
Subtle depression in iii and AVF suggests reciprocal change and also maybe I see down up t wave pattern in iii and avf
V5 looks like a check mark.
Big aloha from hawaii! Thank you so much for your UA-cam videos. Tremendous resource!
Aloha.. and thank you for you kind comments. Please do share the with your colleagues in Hawaii as well.
It looks like you have opted for the cathlab.
I'll give it some more time before I publically post the answer. Lets give others a chance as well.
If you don't want to wait for the answer, just drop me email at practicalecgcourses@gmail.com. And I will send you a direct relpy.
Thank you for taking the time to reply.
Nice video sir.. Thank you so much 👍👍
Thank you. Glad you liked it..
Thank you so much sir...
Well explained class👍🏻
Thank you 😊
Hello doc .
2 things come to my mind on the final ECG
1. Sinus rhythm with LVH and early repolarisation pattern
2. STEMI - ST elevation V2 to V6 with reciprocal changes in 3,avf
Thank you for you response. So it looks like you have opted for the cathlab.
I'll give it some more time before I post the answer. Lets give others a chance as well.
If you don't want to wait for the answer, just drop me email at practicalecgcourses@gmail.com. And I will send you a direct relpy.
Just a comment on your answer though - As far as I know, LVH is generally not diagnosed by using voltage criteria in patients under 35 years of age. Some places they say you shouldn't use it under 40 years. If you think about it, most of the ECGs of young adults show high voltages - that's usually not due to LVH - could be other factors like thin chest wall etc.
Thx Dr Obaid❤
You are welcome ☺
@@PracticalECGCourses DR Obaid, Could I have the answer about the ecg in the end of the video? Please let me know the answer. Thank you🙏🏻
@@queeniefung7514 Hi, I have sent you an email with the answer. Hope you find it useful.
@@PracticalECGCourses thank you Dr Obaid and I learn a lot from your informative channel🫶🏻
Hi Dr Obaid...this whole concept is a new thing for me & I greatly appreciate your effor and time.
He would have to go to the cathlab as it looks like he has tall R waves with q waves which could be suggestive of HOCM.
Could you kindly put the answer for thr question.
Hi Neethu, thank you for your response. I will send you the final answer for the ECG.
if it was up to me every one goes to the cathlab case closed time is crucial in ACS patients
While I can understand your sentiment behind sending everyone to the cathlab, sending everyone to the cath lab will result in a wastage of resources, especially human resources during out of hours. And that will again delay access to the cathlab for patients who need it.
It is important to be able to differentiate those who needs immediate cath lab activation from those who don't. In my opinion, if everyone knew how to interpret ECGs well, then we can have a more judicious use of our cath lab resources - the ones who needs it, gets it immediately & the ones who don't, does not use up resources unnecessarily. Hope that makes sense.
@@drobaid4622 crystal clear 👍
@@drobaid4622I don't think he is truly advicating for *everyone* to go to the cathlab, but more that 72 hours is an absurdly long time to be leaving even the NSTEMI/NOMI patients ischaemic without reperfusion therapy.
Literally me in last ecg:
"THE BIG AHH T W-"'
🤪