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57 year old male chest pain

by on May 14, 2011

57 year old male patient fishing at his lake house when he began to have substernal chest discomfort. He self medicated with NTG x 2 with no relief. He states history of angina but usually one NTG relieves his pain. He states that he also has mild shortness of breath. Pain is 4/10 and nothing seems to make pain better. Skin w/d and lungs are clear and equal.
BP 130/50
RR 16
SP02 98% room air

Ekg obtained from ER

How do you wish to proceed with this patient?

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From → Case File, Education

2 Comments
  1. Anonymous permalink

    Inferior MI, maybe with some septal involvement. St-elevation in II(borderline), III, aVF, and V1. MONA protocol, transport w/ STEMI alert.
    also, has some PJC’s, hopefully those get knocked out with nitro/O2

  2. Coworker permalink

    Inferior Stemi I agree in 3 and AVF. O2 15lpm NRB, ASA. one more NTG. and ask for 10 mg of Morphine depending on B/P after NTG. Tx emergent.

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