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The American College of Cardiology released a new consensus statement, “Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: A Report of the American College of Cardiology Solution Set Oversight Committee“. This document has several algorithms for managing chest pain – from high-sensitivity troponin algorithms to chest pain risk disposition pathways. However, one major update is the incorporation of several “STEMI” equivalents.

It has become increasingly publicized, primarily due to Stephen Smith and Pendell Meyers, that the STEMI vs NSTEMI dichotomy neglects many patients who may benefit from reperfusion due to Occlusion Myocardial Infarctions. This update incorporates some other signs as “STEMI Equivalents” and recommends these patients be treated just as those with STEMI.