In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the February 2026 Emergency Medicine Practice article, Emergency Department Diagnosis and Management of Acute Coronary Occlusion

00:00 - Introduction & Welcome

01:21 - Episode Overview: Acute Coronary Occlusion

02:06 - Why This Topic Matters: Statistics & New Guidelines

03:35 - Nomenclature: ACO vs STEMI/NSTEMI

06:15 - Differential Diagnosis for STEMI

07:41 - Pre-Hospital Care & EMS Role

11:37 - Patient History & Presenting Symptoms

12:28 - Physical Examination Findings

14:54 - EKG: The Most Important Test

17:00 - STEMI Definition & Criteria

20:32 - STEMI Equivalents: Scarbosa Criteria

22:40 - Smith Modified Scarbosa Criteria

24:10 - Hyperacute T Waves

25:30 - Posterior STEMI

28:40 - De Winter Sign

29:38 - Non-STEMI EKG Findings

31:30 - AVR ST Elevation

32:47 - Wellens Syndrome

33:54 - Reciprocal ST Segment Changes

36:15 - Inferior MI Patterns

37:54 - Laboratory Testing

39:51 - Imaging: Chest X-Ray & Echocardiography

42:25 - Supplemental Oxygen: What the Evidence Shows

44:50 - Analgesia & Pain Management

46:35 - Pharmacotherapy: Aspirin & Antiplatelet Agents

49:18 - Reperfusion Therapies & Thrombolytics

53:05 - Cardiac Arrest in STEMI Patients

53:55 - Closing Remarks & CME Information

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