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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