Twitter | Search | |
Stephen W. Smith
Prof of EM at Hennepin with expertise in ECG, esp Acute MI. Author of book, chapters, papers. Google scholar profile: .
4,357
Tweets
302
Following
18,565
Followers
Tweets
Stephen W. Smith 3h
Reply Retweet Like
Stephen W. Smith 6h
Read this full text article on the OMI paradigm, from International Journal of Cardiology: Prospective, real-world evidence showing the gap between ST elevation myocardial infarction (STEMI) and occlusion MI (OMI)
Reply Retweet Like
Stephen W. Smith 20h
Reply Retweet Like
Stephen W. Smith 22h
Any ECG, including completely normal, is compatible w OMI of any location. In such cases, clinical is critical!! This ECG suggests RCA OMI: minimal inferior STE, some STD in aVL, terminal QRS distortion in III & aVF (been studying this & is important), and STE in V1 (RV MI).
Reply Retweet Like
Stephen W. Smith 23h
They are mostly very deep, not bizarre, and located in one coronary territory only. So as long as the clinical story fits, I would say LAD Wellens'. Angiogram.
Reply Retweet Like
Stephen W. Smith Aug 20
In academics, this is true for both women & men. I rarely get a speaking fee. When I do, it is a tiny amount. This is what academics should do: create and disseminate knowledge as part of the job, after standing on the shoulders of the giants before us, who also gave for free.
Reply Retweet Like
Stephen W. Smith Aug 20
Replying to @mfkuepp @HarshGMD and 2 others
My formula has an area under the curve of 0.975.
Reply Retweet Like
Stephen W. Smith Aug 20
Replying to @mfkuepp @HarshGMD and 2 others
The heart score without EKG and troponin has an area under the curve of 0.75.
Reply Retweet Like
Stephen W. Smith Aug 20
Replying to @mfkuepp @HarshGMD and 2 others
Furthermore, history alone is extremely inaccurate.
Reply Retweet Like
Stephen W. Smith Aug 20
Replying to @mfkuepp @HarshGMD and 2 others
If you ignore this EKG in someone with a very atypical hisstory, you miss a left anterior descending artery occlusion. This one is diagnostic no matter what the clinical story.
Reply Retweet Like
Stephen W. Smith Aug 20
Elderly with Paced Rhythm, Possible Ischemic symptoms, and an ECG with equivocal Smith Modified Sgarbossa ECG
Reply Retweet Like
Stephen W. Smith Aug 19
There is definitely ischemia. And almost certainly LVH. There is concordant ST depression in V3. Baseline LVH with so-called “strain” has a higher incidence of measurable high sensitivity troponin than LVH without strain. Here’s one paper:
Reply Retweet Like
Stephen W. Smith Aug 19
Reply Retweet Like
Stephen W. Smith retweeted
Jon Cole Aug 16
I went to a plant nursery the other day. They didn’t have what I was looking for, but they did have a Datura section. My eyes get dilated just looking at this picture.
Reply Retweet Like
Stephen W. Smith Aug 17
Ich verstehe die Kommentar nicht völlig.
Reply Retweet Like
Stephen W. Smith Aug 17
Replying to @ShariqShamimMD
Then you are an excellent interventionalist. You wouldn't believe how many cardiologists look at EKGs like this and say they are normal. As you can see, the one in this case thought it was normal but agreed to take the patient.
Reply Retweet Like
Stephen W. Smith Aug 17
Replying to @IftikharKazi
Did you read the post with 12 Example cases? The link is in the post, but here it is again:
Reply Retweet Like
Stephen W. Smith Aug 17
Acute Chest pain in a 50-something, and a "Normal" ECG
Reply Retweet Like
Stephen W. Smith Aug 16
Occlusion of wraparound LAD (to inferior wall also)
Reply Retweet Like
Stephen W. Smith Aug 16
High takeoff of what?
Reply Retweet Like