Stephen W. Smith @smithECGBlog

EM Prof at Hennepin. Co-originator of #OcclusionMI (OMI) paradigm, ECG diagnosis of OMI, trained @PMcardioApp. https://t.co/jutZW7fHFa… #ECG drsmithsecgblog.com Minneapolis Joined June 2011

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Stephen W. Smith @smithECGBlog

2 days ago

Anti-vaxxers don’t pay attention to evidence. Only emotions.

Ian Copeland, PhD @IanCopeland5

3 days ago

Interesting. A national cohort study of 28 million individuals found: No increased risk of 4-year all-cause mortality in individuals aged 18 to 59 years in persons vaccinated against COVID-19. It's almost like antivaxers are liars and had no evidence...

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Robert Herman, MD, PhD @RobertHermanMD

2 days ago

@ka_mumuu Yes!

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Mike Young @micyoung75

3 days ago

At the same Dallas speech excerpted here, Vance named two women, one born in Somalia, as the face of Medicaid fraud, a 46 million dollar case. He did not mention Lawrence Duran, who ran a 205 million dollar Medicare fraud scheme, the largest of its kind at the time, and was sentenced to 50 years. Trump commuted that sentence, wiping out the 87 million dollars in restitution Duran had been ordered to repay. He also did not mention Robert Harshbarger, husband of sitting Republican Congresswoman Diana Harshbarger, pardoned last November after pleading guilty to distributing unapproved Chinese kidney dialysis drugs as FDA approved medication. Independent estimates put the total restitution and penalties wiped out by Trump's healthcare fraud pardons somewhere between one and two billion dollars, money owed to Medicare, Medicaid, and the patients those programs cover that nobody is getting back. Vance picked the immigrant for the speech and skipped the numbers that actually move.

Jonathan Lemire @JonLemire

6 days ago

“The country is almost certainly dirtier, poorer, less prosperous, and in some ways less safe than in 2024. But that’s not because of Democrats or immigrants. It’s because of the people currently running the place.” theatlantic.com/ideas/2026/09/…

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Robert Herman, MD, PhD @RobertHermanMD

2 days ago

@jonnywatt @smithECGBlog @realarainmd @DrAsifQasim @djc795 @PendellM @ShariqShamimMD @MichaelMindrum @SripalBangalore @EM_RESUS @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi @KingsCollegeNHS It would be great to redo the paper, include all patients including false activations (which is another important parameter) and show QoH on index ECG vs. Activation or Standard of care management <2h.

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Stephen W. Smith @smithECGBlog

2 days ago

@jonnywatt @RobertHermanMD @realarainmd @DrAsifQasim @djc795 @PendellM @ShariqShamimMD @MichaelMindrum @SripalBangalore @EM_RESUS @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi @KingsCollegeNHS The only way to achieve that is with rapid ECG diagnosis. Waiting for troponin takes too long.@PMcardioApp queen of hearts can make that diagnosis on the majority of otherwise undetected NSTEMI-OMI instantaneously

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Stephen W. Smith @smithECGBlog

2 days ago

@jonnywatt @RobertHermanMD @PendellM @DrAsifQasim @djc795 @ShariqShamimMD @MichaelMindrum @SripalBangalore @EM_RESUS @realarainmd @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi @KingsCollegeNHS There are very good definitions in many papers. TIMI 0-2 flow with culprit and PCI, or TIMI-3 flow with culprit and PCI and very high peak troponin. This definition has been used in at least a dozen papers.

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Stephen W. Smith @smithECGBlog

2 days ago

@RobertHermanMD @realarainmd @jonnywatt @DrAsifQasim @djc795 @PendellM @ShariqShamimMD @MichaelMindrum @SripalBangalore @EM_RESUS @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi @KingsCollegeNHS Everyone thinks that if the patient gets PCI at all, all is fine. Waiting 1,2,3,4 hours seems not to be OK for some. But those delays, of even 1 hour, result in lost myocardium, death, and heart failure. Why don’t we require DBT of less than 90 minutes for NSTEMI – OMI?

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Stephen W. Smith @smithECGBlog

2 days ago

Very good question @RobertHermanMD

Robert Herman, MD, PhD @RobertHermanMD

2 days ago

@jonnywatt @smithECGBlog @PendellM @DrAsifQasim @djc795 @ShariqShamimMD @MichaelMindrum @SripalBangalore @EM_RESUS @realarainmd @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi @KingsCollegeNHS Among confirmed OMIs—defined very strictly as 100% stenosis, which inevitably misses many OMIs—94.0% (157/167) of STEMI-OMI patients received immediate reperfusion, compared with only 32.3% (31/96) of NSTEMI-OMI patients (p<0.001). So why do you claim you detect all OMIs

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Stephen W. Smith @smithECGBlog

2 days ago

@jonnywatt @RobertHermanMD @PendellM @DrAsifQasim @djc795 @ShariqShamimMD @MichaelMindrum @SripalBangalore @EM_RESUS @realarainmd @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi @KingsCollegeNHS Even in very high functioning systems, STEMI and STEMI equivalents, as diagnosed by doctors, miss a huge number of OMI. There is a big study on this coming out in JACC Cardiovascular interventions on this topic. Should be published any day now. I can't comment more on it.

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Stephen W. Smith @smithECGBlog

2 days ago

@RobertHermanMD @jonnywatt @PendellM @DrAsifQasim @djc795 @ShariqShamimMD @MichaelMindrum @SripalBangalore @EM_RESUS @realarainmd @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi @KingsCollegeNHS Even so, a 1 hour wait is a whole lot of myocardium lost. By 4 hours after onset of chest pain, 80% of the mortality benefit of reperfusion is gone. jamanetwork.com/journals/jama/…

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Roman Sheremeta 🇺🇸🇺🇦 @rshereme

2 days ago

This is truly a great man. He has invested more in Ukraine than 185 countries combined. Meet Howard Buffett, Warren Buffett’s middle son. He is 71 years old. He dropped out of college three times. He drinks Dr Pepper and looks for a McDonald’s wherever he travels. Since the beginning of the war, his foundation has become the largest private donor to Ukraine: $1.4 billion. Over four years, he has personally visited Ukraine 27 times. In April 2022, he saw burned-out agricultural machinery and called the president of John Deere: “How many combines are available in Europe?” “Fifteen. All of them were supposed to go to Russia.” “I’ll take them all.” Then came all the available New Holland equipment in Europe. Altogether, more than 100 tractors and combines were provided to Ukrainian farmers. He even tested demining equipment himself - on his own farm in Illinois, detonating explosives beneath rollers. When a Ukrainian deputy minister expressed doubts, Buffett told him: “Stop counting my tractors. If necessary, I’ll blow up a thousand of them.” Andriy Stavnitser initially asked him for $1 million for Superhumans. Buffett asked how much was needed to build the entire center. “$14 million.” “Okay. And what do you expect in return?” “Nothing. Build it.” Today, his support for Superhumans has reached $77 million, and the center has treated more than 1,700 patients. But his largest area of spending is neither agricultural machinery nor prosthetics. It is food: 642 million meals. And that is only part of it: * 344,000 windows replaced after Russian attacks; * 9 bridges, 4 power plants, 2,500 generators, and 18 DNA laboratories; * Much of Bucha rebuilt with his funding. “I already have more friends in Ukraine than I do at home,” he says. He celebrates birthdays in Ukraine, comes for Christmas, and even has a Ukrainian godson. Friends, this is truly a great man - someone who understands that he cannot take all his money with him when he leaves this world. I simply want to thank him and wish him well. Whatever else one may say, this is real help from a person who had no personal obligation to Ukraine. He simply chose to help. Source: translated from the original text by Oleh Bairak.

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Stephen W. Smith @smithECGBlog

2 days ago

@PendellM @jonnywatt @DrAsifQasim @djc795 @ShariqShamimMD @RobertHermanMD @MichaelMindrum @SripalBangalore @EM_RESUS @realarainmd @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi @KingsCollegeNHS As in this study in a very high functioning STEMI/equiv system: mean time to angiography was 7 hours for "high risk NSTEMI" with OMI. Mortality was 7.8% for OMI; 2.1% for Non-OMI. Queen could have dx'ed 58% on first ECG with 78% specificity

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Stephen W. Smith @smithECGBlog

2 days ago

@PendellM @jonnywatt @DrAsifQasim @djc795 @ShariqShamimMD @RobertHermanMD @MichaelMindrum @SripalBangalore @EM_RESUS @realarainmd @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi @KingsCollegeNHS Also, this guideline recommended pathway is very, very slow. For an occlusion, all the myocardium is dead by the time it is implemented. In fact, “high risk NSTEMI” is really “complication of undiagnosed OMI“

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Stephen W. Smith @smithECGBlog

2 days ago

A Post-ROSC Patient with an unusual ECG Pattern! drsmithsecgblog.com/a-post-rosc-pa… @MagnusNossen

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Pendell Meyers @PendellM

2 days ago

@cardiopepe @ecgrhythms In addition to Queen of Hearts (for ACS), did you know that we have an acute right heart strain AI ECG model? Here is what it thinks about this ECG. I think the patient could have gotten better care if this had been available.

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Stephen W. Smith @smithECGBlog

3 days ago

@docmoiz66 @ShariqShamimMD @EM_RESUS @realarainmd @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi @PMcardioApp how best to answer?

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Stephen W. Smith @smithECGBlog

3 days ago

Opinion | Trump Has Finally Lost the Plot - The New York Times A must read. Argues that our resistance in Minneapolis was the turning point. nytimes.com/2026/09/19/opi…

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Stephen W. Smith @smithECGBlog

3 days ago

@Frances98392343 @ShariqShamimMD @EM_RESUS @realarainmd @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi It is very interesting. The queen finds that other leads are more important than the leads that we think are important. She has a lot more data to go on than we do.

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Stephen W. Smith @smithECGBlog

3 days ago

Summary: in 1675 in Virginia, poor indentured white and blacks were aligned and became rebellious against the Rich. The rich won by the old method of divide and conquer. Enslave the blacks and free the poor Whites. The age-old strategy worked. heathercoxrichardson.substack.com/p/september-19…