About the Podcast
This Week in Cardiology is hosted by Dr. John Mandrola, a practicing cardiologist and writer, known for sharp insights into clinical research and evolving paradigms in cardiovascular medicine. The podcast highlights evidence that challenges long-held dogma and impacts real-world care.
Summary of the Episode
In this episode, Dr. Mandrola reviews a JACC Advances state-of-the-art paper questioning the long-standing STEMI/NSTEMI classification and proposing a shift to Occlusion MI (OMI) vs non-OMI.
- Roughly half of patients with acutely occluded coronary arteries do not show ST elevation on ECG.
- Nearly 1 in 3 NSTEMI patients actually have an occlusion and could benefit from emergent PCI.
- The current paradigm hides false negatives — patients with occlusion but without ST elevation are mislabeled as NSTEMI, delaying life-saving treatment.
- Authors propose four steps:
- Change the language to OMI vs non-OMI.
- Update the medical record to reflect OMI vs non-OMI.
- Transition “code STEMI” to “code OMI.”
- Improve early diagnosis in prehospital and ED settings using AI, ECG expertise, and point-of-care ultrasound.
- Dr. Mandrola stresses that AI tools like PMcardio Queen of Hearts™ and better ECG education can help identify subtle occlusions often missed under the old paradigm.
“This may be the most important topic I’ve covered in a long time: OMI, not STEMI or NSTEMI. It’s time for a Kuhn-like scientific revolution.”
— Dr. John Mandrola, This Week in Cardiology
🎧 Listen to the episode: Official page | Spotify | Apple Podcasts
