From ST Elevation MI to Occlusion MI: the new paradigm shift in Acute Myocardial Infarction. New @JACCJournals #JACCAdvances state-of-the-art review with Jose Nunes de Alencar, @AslangerE, @PendellM and @smithECGBlog sciencedirect.com/science/ar…

Pleased to share our DIFOCCULT-3 substudy in JACC: Cardiovascular Interventions. In 4,398 patients without diagnostic STE, OMI/NOMI triage doubled ACO identification within 2 h without reducing angiographic yield. pubmed.ncbi.nlm.nih.gov/4286…

Excited for #ACEP26 this week, and the opportunity to speak on #ECG interpretation, #AI tools like @PMcardioApp, and the paradigm shift from #STEMI to #OcclusionMI. @ACEPNation

🚨 Tickets are selling fast as 300+ EM colleagues are already registered for #EMCasesSummit. 🌎 World-class EM faculty 💬 Interactive talks & discussion 🚑 Virtual simulations 🎓 CME from home 3 days to reinvigorate your practice. Nov 19–21 EMCasesSummit.com

Here are examples of the true South African flag sign, where STE is limited to leads I, aVL and V2, due to an occlusion of the 1st diagonal: emergencymedicinecases.com/e…

50-year old with chest pain: serial ECG ‘STEMI negative:’ does the patient have Occlusion MI (OMI)? drsmithsecgblog.com/50-year-… Highlights the stupidity of the NSTEMI guidelines: "NSTEMI" is worthless, and no one follows the "high risk" NSTEMI guidelines. @ECGcases @PMcardioApp

🚨 Update to OMIGuide! Huge shoutout to Mriganka Nerkar, MS4, who led a major expansion of the guide - adding 100+ new cases from Dr. Smith’s ECG Blog since our original launch in 2023! Check out the updates at omiguide.org @smithECGBlog @PendellM @WillyFrick

75 year-old with sudden shortness of breath. What’s the cause of the wide complex tachycardia? #ECG #EKG #cardiotwitter heartsecgcourse.com/ecg-of-t…

Queen of Hearts Now FDA Approved!! What’s her take on this “Non-diagnostic” ECG? drsmithsecgblog.com/queen-of… @PMcardioApp

We've built acute MI care around STEMI criteria, but are ECG thresholds missing too many occluded arteries?⚡ 1 in 3 patients labeled NSTEMI may actually have a totally occluded culprit artery, often waiting hours longer for reperfusion. ow.ly/mvLY50ZIfyn

50 year-old with weakness. Is this ischemia? #ECG #EKG #cardiotwitter heartsecgcourse.com/ecg-of-t…

🚨 The September 2026 issue of #CJEM is live! This month's issue brings together 21 articles tackling some of emergency medicine's biggest challenges and opportunities: 🔹 ED crowding and patient flow 🔹 Interhospital transfers 🔹 Climate change and emergency care 🔹 Bronchiolitis management 🔹 Pediatric suicidal ideation and ketamine 🔹 Pain assessment in older adults 🔹 Stroke care updates 🔹 ECG competency in EM residency training 🔹 Simulation-based education and PoCUS Featured articles include: 📖 Just the Facts: Can we “fix” emergency department crowding? Lessons from EM:POWER 📖 Just the Facts: Bronchiolitis in the pediatric population 📖 Original research on Canadian interhospital transfers, climate change impacts on pediatric emergency medicine, ketamine for pediatric suicidal ideation, and more. Read the full issue here: 🔗 link.springer.com/journal/43… #EmergencyMedicine #CJEM #FOAMed #MedTwitter #PedsEM #Stroke #PoCUS #MedEd #PatientFlow #HealthSystems #CAEP

🚨 EM CASES SUMMIT 2026 🚨 🌎 Nov 19–21 • ONLINE 🔥 World-class EM faculty 🩺 Practice-changing talks 🚑 Procedures + resus simulations 💬 Expert panels 🎓 CME 🎁 Giveaways ▶️ 3 months access to all talks Tickets on sale now! EMCasesSummit.com

@PMcardioApp @ECGcases

Just published Ed and European Hart Journal Acute cardiovascular Care @PMcardioApp @josenalencar @ECGcases academic.oup.com/ehjacc/adva…

Congratulations to @RodrigoZoniOK on leading our paper: Reconsidering fibrinolysis in selected patients with non–ST-elevation acute coronary syndrome: A hypothesis-generating, research-based framework #NSTEMI #ACS #reperfusion 🔗@AmericanHeartJ sciencedirect.com/science/ar…

New from @jem_journal : Diagnostic dilemma: acute aortic syndrome vs acute coronary occlusion in the emergency department jem-journal.com/article/S073…

The 5th universal definition of MI invokes the concept of "regional ST-segment depression" due to supply-demand imbalance.🤦‍♂️ This concept is incorrect and misleading, because subendocardial ischemia DOESN'T localize to any region. There are really just TWO possible patterns of acute myocardial ischemia on an ECG: [#1] Subendocardial ischemia (diffuse STD). [#2] Transmural ischemia (which often causes regional STE and regional ST depression due to reciprocal changes). The concept of "regional ST-segment depression due to supply-demand mismatch" is misleadingly dangerous, because this is often *incorrectly* invoked to explain regional reciprocal STD. This causes clinicians to *miss* the true diagnosis of transmural infarction (e.g., posterior transmural ischemia causing anterior STD). It would be safest to eliminate the myth of "regional ST-segment depression due to supply-demand mismatch" in order to force ECG readers to choose between the only two real ECG manifestations of ischemia: subendocardial ischemia or transmural ischemia.

90 year old with weakness, vomiting and paced rhythm - what treatment is needed? #ECG #EKG #cardiotwitter heartsecgcourse.com/ecg-of-t…

Bradycardia in the emergency department: quality measures and opportunities for improvement sciencedirect.com/science/ar…

4 patients with ST elevation, infection, and elevated troponin: which is Occlusion MI and which is myocarditis? drsmithsecgblog.com/4-patien… @PMcardioApp @ECGcases