MioAtlas
Atlas coronaire et ischémie 3D

Simulateur SCAEST 3D : territoires coronaires et équivalents OMI

Visualisez les répercussions bioélectriques et tissulaires de l'occlusion coronaire aiguë sur un cœur 3D interactif avec dérivations standard et accessoires.

Coronary tree modeling & myocardial perfusion

The MioAtlas coronary engine reconstructs the three-dimensional architecture of the 11 major arterial branches over the ventricular epicardium: left main (LMCA), left anterior descending (LAD) with D1 and D2 diagonals, circumflex (LCx) with OM1 and OM2 marginals, and right coronary artery (RCA) with acute marginal (AM), posterior descending (PDA), and posterolateral (PLB) branches.

Each stenosis or occlusion point (parameter ter=...) defines an ischemic myocardium-at-risk volume based on vessel location and coronary dominance. Transmural injury is mapped onto the standardized AHA/ACC 17-segment model (Cerqueira et al. 2002). Cellular injury currents during depolarization and repolarization yield ST-vector shifts recorded on the live 120 Hz ECG monitor.

OMI paradigm: beyond strict millimeter criteria

The simulator integrates 8 ECG phenotypes reflecting the modern Occlusion Myocardial Infarction (OMI) paradigm. This framework recognizes that many acute transmural or critical subtotal occlusions do not meet traditional millimeter ST elevation thresholds in contiguous leads.

Modeled patterns include De Winter hyperacute T-waves in critical proximal LAD stenosis, Wellens biphasic/inverted T-wave reperfusion patterns (Types A and B), Aslanger inferior infarction with multivessel disease, giant Shark-Fin triangular waves, and modified Sgarbossa-Smith criteria in LBBB and ventricular pacing.

Biophysical variables: evolutionary phases & coronary dominance

ECG manifestations change dynamically with ischemic duration and coronary anatomy. The engine allows interactive selection of infarction phases (ph=HIPERAGUDA, AGUDA, ESTABLECIDA, SUBAGUDA, or CRONICA), demonstrating the progression from hyperacute T-waves to pathological Q-wave necrosis (>30 ms) and T-wave inversion.

Dominance settings (dom=RIGHT, LEFT, CODOMINANT) redistribute vascular supply to the inferior and posterior LV, altering whether maximum ST elevation appears in lead III (right dominant) or lead II with inferolateral involvement (left dominant).

Explorer l'arbre coronaire en 3D

Lancez le simulateur en mode coronaire avec infarctus antérieur de l'IVA et modifiez le territoire, la dominance ou la phase temporelle.

Ouvrir le simulateur coronaire 3D

18 Sites d'occlusion coronaire (SCAEST / Infarctus transmural)

Localisations anatomiques modélisées sur le tronc commun, l'IVA, la circonflexe, la coronaire droite et les branches secondaires.

Tronc commun gauche (TCG / LMCA)

1 location

Artère interventriculaire antérieure (IVA / LAD)

5 locations

Artère circonflexe (Cx / LCx)

2 locations

Artère coronaire droite (CD / RCA)

4 locations

Branches coronaires (diagonales, marginales, IVP, PLB)

6 locations
Paradigme OMI

8 Phénotypes électrocardiographiques et équivalents OMI

Profils ischémiques à haut risque traduisant une occlusion coronaire active sans élévation ST classique.

Hemodynamic and electrophysiological foundation

The 11-artery coronary model and myocardium-at-risk mapping build upon standardized American Heart Association anatomical classifications (Cerqueira et al. 2002; Austen et al. 1975). Culprit artery correlation and reciprocal leads follow European Society of Cardiology and American College of Cardiology consensus guidelines (Thygesen et al. 2018; Ibanez et al. 2018).

View full methodological specification → View ECG monitor technical documentation →