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.
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.
Parallax by Ankur Kalra · EP 121: OMI/NOMI: A Paradigm Shift in Myocardial Infarction Diagnosis With Dr Stephen Smith
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.
Parallax Ep 121 with the estimable Dr. @smithECGBlog at @HennepinHC/@umnmedschool in Minneapolis, MN, my Alma Mater. We discuss his groundbreaking OMI/NOMI paradigm, challenging the traditional #STEMI vs non-STEMI terminology that has been the cornerstone of ACS management.… pic.twitter.com/VFzOrFkVgj
— Ankur Kalra (@AnkurKalraMD) October 21, 2024
We just published this in The Journal of the American College of Cardiology — Advances (JACC Advances) "State of the Art Review". It is a REALLY interesting read, using quotes from Thomas Kuhn's book "The Structure of Scientific Revolutions" (the book that coined the word… t.co/50bwiB1RlB
— Stephen W. Smith (@smithECGBlog) October 8, 2024
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 linkhere.
References
- 1. McLaren J, et al. From ST-Segment Elevation MI to Occlusion MI: The New Paradigm Shift in Acute Myocardial Infarction. JACC Advances. 2024.
- 2. Herman R, Meyers HP, Smith SW, et al. International evaluation of an artificial intelligence-powered ECG model detecting acute coronary occlusion myocardial infarction. Eur Heart J Digital Health. 2023;5:123-133.
Share this article
About PMcardio
PMcardio is a CE-marked Class IIb AI medical device that interprets any 12-lead ECG — from a photo or a digital file — in seconds. It detects 50+ ECG findings, including occlusion myocardial infarction (OMI) — the acute coronary occlusions that conventional STEMI criteria miss in over half of cases. Its Queen of Hearts™ OMI model holds FDA Breakthrough Device Designation, and PMcardio is already used by 100,000+ clinicians who have analyzed more than 2.5 million ECGs.
About Powerful Medical
Powerful Medical is a medical-technology company using artificial intelligence to transform how cardiovascular disease — the world’s leading cause of death — is diagnosed. Founded in 2017, it built PMcardio, the world’s first AI medical device to detect acute coronary occlusion (OMI) from an ECG. Its research is published in the European Heart Journal – Digital Health and validated across 25+ clinical studies, and its Queen of Hearts™ model earned FDA Breakthrough Device Designation. To date, PMcardio has supported the detection of 120,000+ heart attacks across 150+ hospital deployments worldwide.
