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37 year old acute chest pain

by on December 11, 2012

EMS responded to home of an average shape 37 year old male patient who was out jogging when he began to have some substernal chest pain that radiates to his left arm.  He stated he was having some mild shortness of breath with nausea but no vomiting.  No significant medical history and on no medications.  He stated he hesitated calling EMS but after a while he got concerned that he was not feeling any better. 

He appears anxious.  Skin is pale and moist.  Lungs clear = bilat. 

BP  100/50  RR 20  HR 56

12 lead obtained

Image

 

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From → Case File

7 Comments
  1. Proof that population risk factors mean nothing when you’re dealing with patients on an individual level. Nice case!

  2. Thanks for the post. Unfortunately the image is a little blurry but I would say that’s at least an anterior MI.

  3. huskerlover permalink

    Inferior

    • Of course, inferior MI, huskerlover, when I read my comment now I am feeling embarrassed. Rookie mistake. Thanks for pointing that out. :O)

  4. Anonymous permalink

    info.STEMI with reciprocal changes in right anterior.it appears RCA is evolved artery

  5. Emad AL-nounou permalink

    Inferior MI with reciprocal in anterior leads , i think the third part of RCA is indicted

  6. Talin permalink

    Inferior wall MI with right ventricle and posterior wall involvement. If you notice there is greater ST-Elevation in Lead III then in Lead II. This is an indication of an infarction to the right ventricle. Also there is ST-Depression in Leads V1 and V2 this is further indication of posterior wall involvement “reciprocal changes.”

    If a 15Lead ECG was conducted: RV4, V8 and V9
    I would be extremely confident that there would be ST-Elevation in these three additional leads.

    My interpretation of this ECG: Inferior/Posterior Wall Acute MI
    Possible occluded arteries: Right Coronary Artery and Posterior Descending Artery

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