Unfortunately, this was not appreciated, and the patient went into ventricular fibrillation approximately 30 min after the 2nd ECG, and could not be resuscitated.
Epigastric pain can be due to inferior OMI
Beware any discordant ST elevation that is greater than 15%. If greater than 20%, it is very likely OMI, even if it does not meet the 25% criterion.
Criteria of any kind are only guidelines and not to be strictly followed!
The modified Sgarbossa criteria are only 80% sensitive for OMI!!
The STEMI criteria in normal conduction are only 75% sensitive for OMI!!
The 4-variable LAD occlusion formula is 80-90% sensitive at a cutoff of 18.2!!!