Robert Herman, MD, PhD

Cardiology Researcher @CardioAalst
Founder @PMcardioApp - AI that reads ECGs & Queen of Hearts (STEMI/OMI)
ECG Educator - weekly cases

[Robert Herman, MD, PhD @RobertHermanMD]

Seeing a clinical need identified in the cath lab at Aalst evolve into a certified medical device and platform that now helps millions of patients worldwide is incredibly rewarding, and exactly the kind of impact that inspired me to pursue medicine!

[Robert Herman, MD, PhD @RobertHermanMD]

@yasermd96 Could’ve saved several hours to PCI!

[Robert Herman, MD, PhD @RobertHermanMD]

@0music6

[Robert Herman, MD, PhD @RobertHermanMD]

@0music6 Ask her

[Robert Herman, MD, PhD @RobertHermanMD]

@max_berrill @smithECGBlog @PendellM Yes, it currently considers all 12-leads for an interpretation. In ECGxplain aVR may show up as a “relevant” lead, but it’s rare — was searching a lot for this example. We are currently reworking and improving this feature.

[Faizan A. @fzn733]

@0music6 I agree with you. Thanks for sharing this. I was hesitant because the de Winter morphology isn’t really present in V1–V3 but you may be right.

Double checked with PMcardio.

[Robert Herman, MD, PhD @RobertHermanMD]

@colyn_edd @smithECGBlog Here 25 mm/sec

[Robert Herman, MD, PhD @RobertHermanMD]

@colyn_edd @smithECGBlog Interesting that's also what Karl thought based on the ECG.

[Andrew Bowman, ACNP, FAEN🤷🏻‍♂️🚑🏥✒️ @AndrewACNP1]

Presented on OMI yesterday for one of our ERs and today one of the nurses who attended picked up on a HATW OMI!!

Proud Papa!!!

[Robert Herman, MD, PhD @RobertHermanMD]

@0music6 Despite the cropped voltage 😡

[Robert Herman, MD, PhD @RobertHermanMD]

@0music6 Here is what QoH thinks!

[Robert Herman, MD, PhD @RobertHermanMD]

@caughtatgully2 @Frances98392343 Karl agrees with others in the thread

[Robert Herman, MD, PhD @RobertHermanMD]

@Tayfun_demir1 @ekgpress @Frances98392343 @EM_RESUS @PendellM @PrecordialSwirl

[Robert Herman, MD, PhD @RobertHermanMD]

@medmalreviewer @ecgchallenge Yeah this should help! We are working hard to get it there ASAP, feel free to send me a an ECG you want to run in the meantime.

[Dr Razi @DrRazi4]

OMI signs detected ‼️‼️🚑🚑

#ecg shows:
1. Clockwise vortex STE with rightward STE V1 and leftward STD V6 + TW/S Wave ratio>0.4 V2 ⏭️ Precordial Swirl
2. Hyperacute TW V2-V4; Lead 1 & aVL
3. Terminal QRS distortion V3
4. Reciprocal STD Inferior Leads

🔺Acute pLAD OMI

[Robert Herman, MD, PhD @RobertHermanMD]

By what definition? Presumably, the COACT and TOMAHAWK trials tell us that patients without millimeters of ST-segment elevation do not benefit from immediate PCI. This patient does not have ST-segment elevation that meets current guideline criteria.

To be clear, I know what the correct diagnosis is, so there is no need to educate me on that. My point is simply to highlight how absurd the situation is: we can recognize an acute coronary occlusion, yet by the definitions used in these trials and guidelines, this patient would not qualify for immediate cath lab activation.

Can you also answer whether you think the ECG above is a STEMI?

[Robert Herman, MD, PhD @RobertHermanMD]

Does this "NSTEMI" with an out-of-hospital cardiac arrest need immediate cath lab activation, or should we follow the guidelines?

Let me know what you think of this #ECG of a 50yo male patient with chest pressure and left arm numbness post ROSC!

[Robert Herman, MD, PhD @RobertHermanMD]

Does this "NSTEMI" with an out-of-hospital cardiac arrest need immediate cath lab activation, or should we follow the guidelines?

Let me know what you think of this #ECG of a 50yo male patient with chest pressure and left arm numbness post ROSC!

[Robert Herman, MD, PhD @RobertHermanMD]

@BakhshiHooman @smithECGBlog @The_Nanashi_O @DidlakeDW @ecgandrhythmRoe @TheECGMedic @DrRazi4 @ShariqShamimMD @IM_Crit_ @Vadeboncoeur_Al @PendellM Is this a STEMI?

[Robert Herman, MD, PhD @RobertHermanMD]

@BakhshiHooman @smithECGBlog @The_Nanashi_O @DidlakeDW @ecgandrhythmRoe @TheECGMedic @DrRazi4 @ShariqShamimMD @IM_Crit_ @Vadeboncoeur_Al @PendellM I'd love to hear your definition of STEMI and "real NSTEMI"