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BEYOND THE ST-SEGMENT IN OCCLUSION MYOCARDIAL INFARCTION (OMI): DIAGNOSING THE OMI-NOUS

EMRE K ASLANGER

Türkiye Acil Tıp Dergisi - 2023;23(1):1-4

Department of Cardiology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey

The ST-segment elevation (STE) myocardial infarction (MI)/non-STEMI (NSTEMI) paradigm has been the central dogma of emergency cardiology for the last 30 years. Although it was a major breakthrough when it was first introduced, it is now one of the most important obstacles to the further progression of modern MI care. In this article, we trace why a disease with an established underlying pathology (acute coronary occlusion [ACO]) was unintentionally labeled with a surrogate electrocardiographic sign (STEMI/NSTEMI) instead of pathologic substrate itself (ACO-MI/ non ACO MI or occlusion MI [OMI]/non OMI [NOMI] for short), how this fundamental mistake caused important clinical consequences, and why we should change this paradigm with a better one, namely OMI/NOMI paradigm.