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78 year old female chest pain

by on April 1, 2011

This case was sent to me by a friend at a neighboring county. Here is his exact words as it relates to the patient

“78 WF Onset pain 1015, subternal rad to back and neck at rest. Waited at home then drove to MD office, 10 min in lobby, EKG by MD Office. MD gave ASA and NGTx1 pain from 3 to 0. Pain free w/EMS Arrival and throughout. Arrival, looked at the office 12 lead sumon helo to land 12 miles from me. Enroute all clothing Off, PIV x 2, EKG x 5, 02, No other drugs. Helo on Ground, pt in cath lab as I type this…no outcome yet.”

I will point out that the closest PCI center they use is approximately one hour away by ground in non rush hour traffic.

Here is the EKG.

From → Case File

  1. Certainly agree with the monitor: evolving inferioposterior MI, RCA maybe? Tough to tell on the image if STE III is actually greater than STE II though, maybe LCX. Definitely makes me happy I am 15 minutes from a PCI center, can’t imagine calling a bird for a STEMI.

  2. Yeah me too Christopher, I am grateful that I am within 15-20 mins to three PCI centers in my area.

  3. Mike permalink

    From my town to the closest hospital/PCI center is a minimum of 50 minutes with no traffic, and for a stroke center its nearly 2 hours by ground. Where I work we are are about 65 minutes from the same hospital. Luckily we have small call volumes, but helicopters are very useful to us!

  4. Ben permalink

    Be nice to have PCI, nearest centre to us is 3 hours by road!

  5. Our nearest PCI is an hour and half. Work in St. Clair County, MO. She needs a cath lab right away so calling the helo was the right call in this case. Why? The more time you wait the more muscle loose you have (as I am sure everyone knows). An hour is much to long with an acute MI. Good call by the medic.

  6. Elivation 2-3 and AVF isn’t this an Anterior Wall MI ???
    I see other changes but non are elivations

  7. Danny 2.-3 and AVF are the inferior leads.

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