Dr. Stephen Smith Discusses the OMI Paradigm & PMcardio on the Parallax Podcast

We are excited to announce that Dr. Stephen Smith, a member of Powerful Medical’s Acute Coronary Syndrome Scientific Advisory Board, was recently featured on Parallax, one of the world’s most popular cardiology podcasts hosted by Dr. Ankur Kalra. The episode aired on October 21, 2025, and delved into the groundbreaking OMI/NOMI paradigm (Occlusion MI vs. Non-Occlusion MI), a shift that challenges traditional STEMI vs. NSTEMI terminology in acute myocardial infarction (MI) management.

Challenging the STEMI/NSTEMI Paradigm: A New Approach

Dr. Smith challenged the long-established STEMI vs. NSTEMI framework, arguing that traditional ST-segment elevation is not always a reliable indicator of acute coronary occlusion. During the conversation, he highlighted key evidence from his recent review paper, “From ST-Segment Elevation MI to Occlusion MI: The New Paradigm Shift in Acute Myocardial Infarction,” which underscores the need for a shift towards more accurate diagnostics, such as OMI (Occlusion MI) and NOMI (Non-Occlusion MI)1. The episode also explored advanced electrocardiographic criteria, such as STEMI equivalents, which are crucial for identifying occlusions that traditional methods might miss.

“ST-elevation is just not a very good way of diagnosing acute coronary occlusion. It’s very insensitive, very non-specific and so it does not tell us what we really need to know, which is whether the artery is acutely occluded causing ongoing myocardial infarction and irreversible heart muscle loss.” Prof. Dr. Stephen W. Smith

Furthermore, the discussion emphasized the challenges of disseminating and implementing this paradigm shift in clinical practice, particularly in teaching clinicians refined ECG interpretation skills. 

Validating PMcardio in Acute Coronary Syndrome Care

Dr. Smith and Dr. Kalra also touched upon the transformative role of AI in enhancing diagnostic accuracy in cardiology. They specifically highlighted ongoing global studies validating PMcardio, also known as the Queen of Hearts. By leveraging deep learning algorithms trained on vast ECG datasets, PMcardio can differentiate between OMI and NOMI ECG patterns, leading to faster and more accurate diagnoses. Its advanced diagnostic capability not only reduces diagnostic errors but also significantly expedites times to treatment especially in the NSTEMI-OMI patients, allowing for quicker intervention².

Such advancements exemplify how AI is bridging the gap between traditional clinical practices and state-of-the-art technology, revolutionizing acute cardiac care management and improving patient outcomes worldwide.

From Traditional Practices to Cutting-Edge Technology

Dr. Smith, also known for his influential Dr. Smith’s ECG Blog, continues to be a prominent voice in redefining acute coronary care. His blog, a go-to resource for emergency physicians and cardiologists, offers in-depth case studies and insights into the OMI/NOMI paradigm. Featuring over 1,700 posts primarily focusing on the nuances of ECG interpretation, it showcases the capabilities of PMcardio in diagnosing occlusive MI, setting a new benchmark in cardiology diagnostics. 

To listen to this insightful episode, where Dr. Smith breaks down the science behind the OMI paradigm and shares practical advice for clinicians, visit the podcast link here. 

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