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Dr. Smith's ECG Blog

Instructive ECGs in Emergency Medicine Clinical Content

Associate Editors:
— Pendell Meyers & Ken Grauer (2018)
— Jesse McLaren & Emre Aslanger (2022)
— Willy Frick (2024) — Sam Ghali (2025)

editors

About

Dr. Stephen W. Smith, MD — Professor of Emergency Medicine at the University of Minnesota and founder of Dr. Smith's ECG Blog

Stephen W. Smith, MD

Founder of Dr. Smith’s ECG Blog · Professor of Emergency Medicine, University of Minnesota · Faculty Physician, Hennepin County Medical Center

Dr. Stephen W. Smith is a faculty physician in the Emergency Medicine Residency at Hennepin County Medical Center (HCMC) in Minneapolis, MN, and Professor of Emergency Medicine at the University of Minnesota. Board-certified by the American Board of Emergency Medicine, he founded Dr. Smith’s ECG Blog in 2008 and is internationally recognized for his work on ECG interpretation in acute MI, troponin assays, and the Occlusion MI (OMI) paradigm. The blog is ranked 6th worldwide among Free Open Access Emergency Medicine/Critical Care sites (FOAMed).

Dr. Smith’s Book · The ECG in Acute MI (PDF) · Google Scholar Profile

Clinical Expertise

Emergency Medicine, with an emphasis on Emergency Cardiac Care — particularly chest pain, electrocardiogram (ECG) and troponin interpretation, and Gamma-Hydroxybutyrate toxicity, addiction, and withdrawal.

Education & Training

  • Medical School: Northwestern University, Chicago, IL, USA
  • Residency: Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USA
  • Fellowship: Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USA

Selected Publications

  • Sandoval Y. Smith SW. Apple FS. Present and Future of Cardiac Troponin in Clinical Practice: A Paradigm Shift to High Sensitivity Assays. American Journal of Medicine. April 2016. Online January 2016
  • Meyers HP. Limkakeng AT. Jaffa EJ. Patel A. Theiling BJ. Rezaie SR. Stewart T. Zhuang C. Pera VK. Smith SW. Validation of the Modified Sgarbossa Rule for Diagnosis of STEMI in the Presence of Left Bundle Branch Block. American Heart Journal 170(6):1255-1264; December 2015.
  • Shah ASV. Anand A. Sandoval Y. Lee KK. Smith SW. Adamson PD. Chapman AR. Langdon T. Sandeman D. Vaswani A. Strachan FE. Ferry A. Stirzaker AG. Reid A. Gray AJ. Collinson PO. McAllister DA. Apple FS. Newby DE. Mills NL. For the High-STEACS Investigators. High-sensitivitiy cardiac troponin I at presentation in patients with suspected acute coronary syndrome: a cohort study. The Lancet 386 (10012), 2481-2488; December 19, 2015.
  • Smith SW. Dodd KW. Dvorak D. Henry TD. Pearce LA. Diagnosis of Acute Myocardial Infarction in the Presence of Left Bundle Branch Block using the ST Elevation to S-Wave Ratio in a Modified Sgarbossa Rule.Annals of Emergency Medicine 2012; 60(12):766-776.
  • Smith SW. Khalil A. Henry TD. Rosas M. Chang RJ. Heller K. Scharrer E. Ghorashi M. Pearce LA. Electrocardiographic Differentiation of Early Repolarization From Subtle Anterior ST-Segment Elevation Myocardial Infarction. Annals of Emergency Medicine 2012; 60(1):45-56.
  • Zvosec DL. Smith SW. McCutcheon R. et al. Adverse Events, Including Death, Associated with the Use of 1,4-butanediol. New England Journal of Medicine 2001; 344(2):87-94.

Honors & Affiliations

  • Professor of Emergency Medicine, University of Minnesota
  • Board Certified, American Board of Emergency Medicine
  • Member, American College of Emergency Physicians
  • Member, Society for Academic Emergency Medicine
  • Dr. Smith’s ECG Blog ranked 6th worldwide among Free Open Access Emergency Medicine/Critical Care sites (FOAMed)

Outside of medicine, Dr. Smith enjoys biking, skiing, reading, and whitewater kayaking.

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Dr. Pendell Meyers, MD — Assistant Professor of Emergency Medicine at Carolinas Medical Center and co-editor of Dr. Smith's ECG Blog

H. Pendell Meyers, MD

Co-Editor, Dr. Smith’s ECG Blog · Assistant Professor of Emergency Medicine, Carolinas Medical Center

Dr. H. Pendell Meyers is an Assistant Professor of Emergency Medicine at Carolinas Medical Center and co-editor of Dr. Smith’s ECG Blog since 2018. He is a co-author of the OMI Manifesto and one of the most influential voices advancing the Occlusion MI paradigm — the shift from STEMI/Non-STEMI to OMI/NOMI as the framework for diagnosing acute coronary occlusion in emergency medicine.

Education & Training

  • Medical School: Duke University, Durham, NC, USA
  • Residency: Emergency Medicine, Stony Brook University Hospital, Long Island, NY, USA

Selected Publications

  • Meyers HP. Limkakeng AT. Jaffa EJ. Patel A. Theiling BJ. Rezaie SR. Stewart T. Zhuang C. Pera VK. Smith SW. Validation of the modified Sgarbossa criteria for acute coronary occlusion in the setting of left bundle branch block: a retrospective case-control study. Am Heart J 2015;170;1255-1264.
  • Meyers HP. Jaffa EJ, Smith SW, Drake W, Limkakeng AT. Evaluation of T-wave morphology in patients with left bundle branch block and suspected acute coronary syndrome. J Emerg Med. 2016 Sep;51(3):229-37.
  • Meyers HP, Smith SW. Dynamic T-wave inversions in the setting of left bundle branch block. Am J Emerg Med. 2016;35;938e5-938e7.
  • Newman DH, Ackerman B, Kraushar ML, Lederhandler MH, Masri A, Starikov A, Tsao DT, Meyers HP, Shah KH. Quantifying patient-physician communication and perceptions of risk during admissions for possible acute coronary syndromes. Ann Emerg Med 2015 Jul;66(1):13-8.

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Dr. Ken Grauer, MD — Professor Emeritus of Family Medicine at the University of Florida and associate editor of Dr. Smith's ECG Blog

Ken Grauer, MD

Associate Editor, Dr. Smith’s ECG Blog (since 2018) · Professor Emeritus of Family Medicine, University of Florida College of Medicine

Dr. Ken Grauer is Professor Emeritus in the Department of Community Health & Family Medicine at the University of Florida College of Medicine, and an associate editor of Dr. Smith’s ECG Blog since May 2018. He is the principal author of more than 15 books on ECG and arrhythmia interpretation, founder of KG/EKG Press, and one of the most prolific ECG educators in family medicine.

Education & Training

  • Medical School: University of Lausanne, Switzerland (1970-73); SUNY @ Syracuse, 1973-75 (MD Degree).
  • Residency: Family Medicine at St. Margaret’s, Pittsburgh, PA, 1975-78.

Career

Dr. Grauer practiced as an Emergency Physician at Broward General in Ft. Lauderdale, FL from 1978–80. He then served as full-time core faculty at the Family Medicine Residency Program at the University of Florida from 1980–2010, including a long tenure as Assistant Director of the Residency Program from 1983–2009. He has been recognized with numerous local, state, and national teaching awards throughout his career.

ACLS Teaching

Dr. Grauer served as an ACLS instructor from 1978–2012, was Affiliate ACLS Faculty for Florida from 1983–1998, and former National ACLS Affiliate Faculty — having participated in or directed well over 100 Provider or Instructor Courses during his career.

Publications & Presentations

Principal author of more than 15 books, plus numerous study aids on ECG/arrhythmia interpretation and ACLS. Principal author of over 75 cardiology-related articles for family physicians, and presenter at over 350 statewide and national presentations, including numerous ECG workshops. Founded KG/EKG Press in 1998 and developed the ECG Competency Assessment for Family Medicine (2012–2021).

His ECG Interpretation Blog (since 2010) is available at ecg-interpretation.blogspot.com.

Dr. Grauer is conversant in French and Spanish, with working knowledge of German, Italian, Portuguese, and Hebrew. Outside of medicine, he is an avid ballroom dancer, plays piano and keyboard, enjoys horseback riding, and is a proud grandfather of two.

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Dr. Jesse McLaren, MD — Assistant Professor of Family & Community Medicine at the University of Toronto and associate editor of Dr. Smith's ECG Blog

Jesse McLaren, MD

Associate Editor, Dr. Smith’s ECG Blog (since 2022) · Assistant Professor, Department of Family & Community Medicine, University of Toronto

Dr. Jesse McLaren is an Assistant Professor in the Department of Family & Community Medicine at the University of Toronto and an associate editor of Dr. Smith’s ECG Blog since 2022. He has authored the monthly ECG Cases blog at Emergency Medicine Cases since 2019, with research focused on reducing diagnostic time for acute coronary occlusion in the emergency department.

Education & Training

  • Medical School: University of British Columbia, Vancouver, Canada
  • Residency: McGill University, Montreal, Canada

Selected Publications

  • McLaren JTT, Meyers HP, Smith SW, Chartier LB. From STEMI to Occlusion MI: paradigm shift and ED quality improvement. CJEM 2022 APr;24(3):250-255
  • McLaren JTT, Taher AK, Chartier LB. Flattening the other curve: reducing emergency department STEMI delays during the COVID-19 pandemic. Am J Emerg Med 2021 Nov;49:367-372
  • McLaren JTT, Taher AK, Kapoor M, Yi SL, Chartier LB. Sharing and Teaching Electrocardiograms to Minimize Infarction (STEMI): reducing diagnostic time for acute coronary occlusion in the emergency department. Am J Emerg Med 2021 Oct;48:18-32
  • McLaren JTT, Kapoor M, Yi SL, Chartier LB. Using ECG-to-activation time to assess emergency physicians’ diagnostic time for acute coronary occlusion. J Emerg Med 2021 Jan;60(1):25-34

Follow Dr. McLaren on Twitter/X at @ECGcases.

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Dr. William (Willy) Frick, MD, FACP — clinical cardiac electrophysiology fellow and associate editor of Dr. Smith's ECG Blog

William (Willy) Frick, MD, FACP

Associate Editor, Dr. Smith’s ECG Blog (since 2024) · Fellow in Clinical Cardiac Electrophysiology, Washington University in St. Louis

Dr. William (Willy) Frick is a Fellow in clinical cardiac electrophysiology at Washington University in St. Louis and an associate editor of Dr. Smith’s ECG Blog since 2024. His research focuses on artificial intelligence ECG models for detecting acute coronary occlusion and on advancing the Occlusion MI paradigm in acute coronary syndrome.

Education & Training

  • Medical school: University of Kentucky College of Medicine
  • Residency: Indiana University
  • Cardiology fellowship: St. Louis University
  • Electrophysiology fellowship: Washington University in St. Louis

Selected Publications

  • Meyers, H., Sharkey, S., Herman, R., de Alencar, J., Shroff, G., Frick, W., Smith, W. (2025). Failure of standard contemporary ST-elevation myocardial infarction electrocardiogram criteria to reliably identify acute occlusion of the left anterior descending coronary artery. European Heart Journal: Acute Cardiovascular Care. https://doi.org/10.1093/ehjacc/zuaf037
  • Frick, W., McLaren, J., Meyers, H., Smith, S. (2025). Occlusion myocardial infarction: A revolution in acute coronary syndrome. Advances in Interventional Cardiology, 21(2), 139-143. https://doi.org/10.5114/aic.2025.151161
  • Frick, W., Herman, R., Simancik, F., Mar, P. (2024) First In Human: T-Wave Alternans with Three-Beat Periodicity. JACC: Clinical Electrophysiology. https://doi.org/10.1016/j.jacep.2024.06.029
  • Frick, W., Atallah, I., Saraf, R., Lin, K.-Y., Lin, C.-J., Mar, P. (2024). PO-02-071 Single center retrospective validation of an artificial intelligence ECG model detecting acute coronary occlusion. Heart Rhythm, 21(5). https://doi.org/10.1016/j.hrthm.2024.03.803.

Outside of medicine, Dr. Frick enjoys hot sauce (up to and including the spiciest peppers on the planet), live music, and his two dogs.

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