The 2025 Australian ACS Guidelines have just been published.

Brieger, D, Cullen, L et al. National Heart Foundation of Australia & Cardiac Society of Australia and New Zealand: Comprehensive Australian Clinical Guideline for Diagnosing and Managing Acute Coronary Syndromes 2025. Heart, Lung and Circulation (2025) 34, 309–397 1443-9506/25/$36.00 https://doi.org/10.1016/j.hlc.2025.02.102.

At a recent EMCORE Conference, the second author Prof Louise Cullen, presented the New STEMI Equivalent Guidelines, with multiple ECG examples. The 16 minute video of cases and discussion, is an important one, to understand the subtleties of some of these presentations and is shown below.

The New STEMI Equivalents include:

1. Regional STE with reciprocal STD
2. High lateral MI
3. Posterior MI
4. Right Ventricular MI
5. De Winter T waves
6. Modified Sgarbossa Criteria