Constant Vigilance

I spent a long time trying to think of a punny title for this. Something to do with OMI / Ommmm or OMIGOD. My trouble with wordplay is not the point here. The point is that everything you know is a lie. Alright, I’m exaggerating – but this EMCrit article, recommended to the residents by one of our attendings, makes an excellent argument in favor of abolishing STEMI/NSTEMI terminology when making decisions about myocardial infarctions. I appreciate the reminder that everything should be examined through the “so what?” lens: we look for ST elevation because we use it as a predictor of occlusion, and decision tool for intervention. This article makes a compelling case for why ST segment elevation may not be the best indicator for this. Personally, I’ll have to do a lot more reading and thinking and seeing before I make up my mind, but it’s good food for thought.

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