Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

12
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
12
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

30
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
30
Introduction Cardiac Emergencies01:30

Introduction Cardiac Emergencies

30
Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...
30
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

10
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
10
Angina V: Nursing Management01:20

Angina V: Nursing Management

18
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
18
Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

16
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
16

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

The Case for Building Physician Engagement and Competencies in Quality & Safety… and How to Do It.

Quality management in health care·2026
Same author

Electrocardiogram competency of Canadian emergency medicine residents: curriculum gaps and opportunities for improvement.

CJEM·2026
Same author

OMI: time for early recognition and management of acute coronary occlusion.

The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology·2026
Same author

Evaluating a quality improvement learning collaborative: qualitative evaluation of Using Labs Wisely.

BMJ open quality·2026
Same author

The illusion of simplicity: Diagnostic inconsistencies within the STEMI paradigm.

Journal of electrocardiology·2026
Same author

The cost of false dichotomies in a dynamic disease.

Trends in cardiovascular medicine·2026

Related Experiment Video

Updated: Jul 18, 2025

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

3.5K

Missing occlusions: Quality gaps for ED patients with occlusion MI.

Jesse T T McLaren1, Mazen El-Baba2, Varunaavee Sivashanmugathas3

  • 1Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Emergency Department, University Health Network, Toronto, Ontario, Canada.

The American Journal of Emergency Medicine
|August 23, 2023
PubMed
Summary

ST-elevation Myocardial Infarction (STEMI) guidelines overlook false negatives. The occlusion myocardial infarction (OMI) paradigm reveals that most OMI cases are missed, indicating significant quality gaps in acute coronary syndrome care.

Keywords:
Acute coronary syndromeElectrocardiogramOcclusion myocardial infarctionST-segment myocardial infarction

More Related Videos

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

24.3K
Myocardial Infarction and Functional Outcome Assessment in Pigs
12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

Published on: April 25, 2014

28.0K

Related Experiment Videos

Last Updated: Jul 18, 2025

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

3.5K
A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

24.3K
Myocardial Infarction and Functional Outcome Assessment in Pigs
12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

Published on: April 25, 2014

28.0K

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Diagnostic Accuracy

Background:

  • Current ST-elevation Myocardial Infarction (STEMI) guidelines focus on monitoring false positives but neglect false negatives (non-STEMI with occlusion myocardial infarction [OMI]).
  • Evaluating emergency department (ED) patients with acute coronary syndrome (ACS) using STEMI versus OMI paradigms is crucial for understanding diagnostic gaps.

Purpose of the Study:

  • To assess the hospital course of ED patients with ACS under both STEMI and OMI diagnostic paradigms.
  • To identify discrepancies in diagnosis and treatment between STEMI and OMI classifications.

Main Methods:

  • Retrospective chart review of ACS patients admitted to two academic EDs from June 2021 to May 2022.
  • Patients were categorized into OMI, Non-OMI (NOMI), or MI ruled out (MIRO) based on specific angiographic and troponin criteria.
  • Initial ECGs were analyzed for STEMI interpretation, and admission/discharge diagnoses were compared.

Main Results:

  • Out of 382 patients, 141 had OMI, 181 NOMI, and 60 MIRO.
  • Only 40.4% of OMIs were admitted as STEMI, with significantly longer door-to-cath times for those not admitted as STEMI (1712 min vs. 103 min).
  • A substantial proportion of Non-STEMI patients (32.0%) actually had OMI but were discharged with a Non-STEMI diagnosis.

Conclusions:

  • The current STEMI criteria fail to identify the majority of OMI cases, leading to potential underdiagnosis and delayed treatment.
  • The OMI paradigm highlights significant quality gaps in ACS care, particularly concerning false-negative STEMI diagnoses.
  • Implementing the OMI paradigm can improve diagnostic accuracy and patient outcomes in acute coronary syndromes.