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80 year old man with indigestion

by on December 14, 2011

EMS called to local urgent care for a patient who came in with complaint of left side chest pain that feels like indigestion that won’t go away.  He states that pain started this morning and has not eased up at all so he decided to go for an evaluation.  When asked he stated pain was a 4/10 and did not radiate anywhere.  He otherwise felt normal.  There was no nausea or vomiting, no shortness of breath.  Skin was w/d and lungs were clear.  No JVD present and no weakness or dizziness.  Pt does not have any other complaints at all.  When asked about medical history he relates no coronary issues at all.  On no medication and has no allergies.  The attending Doctor is sending this patient to the main ER for further evaluation and treatment. 

Blood Pressure  130/60

Respiration        16

12 lead obtained



He was given ASA 324mg and Nitroglycerin 0.4mg x 3 with pain staying 4/10.  Addition 12 lead obtained 28 minutes later



From → Case File

  1. Just to clarify, the patient was still experiencing pain when these ECGs were recorded, correct?

    I thought Wellens’ was a pattern seen during pain free periods of reperfusion, but then again, maybe it’s not Wellens’. The progression of dynamic ST and T-wave changes isn’t exactly my forte.

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