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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