How not to miss half of occlusion myocardial infarctions

Abstract

In patients with symptoms suggestive of acute coronary syndrome (ACS), consider occlusion myocardial infarction (OMI) in those with EKGs showing maximal ST depression in leads V1-V4, even if the EKG does not meet ST-elevation MI (STEMI) criteria. In this setting, consider prompt referral for emergent reperfusion therapy. From this study, it appears that STDmaxV1-4 is a specific predictor of posterolateral OMI and should be treated as OMI. Strength of Recommendation: B, based on a single retrospective case-control study.