51 year old female abdominal pain
EMS called out to the home of a 51 year old female patient who has a chief complaint of abdominal pain. She stated that the pain started earlier while at home but she did not think anything of it and went to the gym to work out. She stated that the pain did not seem to increase or decrease during her exercise. She now states that she has some left hand numbness. When questioned about past medical history she stated none and is on no medication either. She denies any shortness of breath and has no N/V. She is requesting to be transported to a local hospital. The paramedic on scene places the patient on a cardiac monitor en route per protocol and obtains the following 12 lead.
Pt is now upgraded to Emergent transport.
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Inferior wall myocardial infarction
af & inferoposterior mi
AF rhytm & inferoposterior MI
Inferior Wall STEMI with reciprocal high lateral changes.
I agree, inferior wall.
I agree .
Inferior wall MI
Inferioposterior wall MI. Note the STD in V1-V3. These are actually reciprocal changes for the posterior wall. Also note greater STE III>II which is sensitive for RVI. Run a V4R-V6R to confirm. IV, ASA, no nitro!!, and I would choose fentanyl over morphine for this patient. This patient is extremely preload dependent and a drop in it could be detrimental.
Atrial fibrillation conrolled rate, STD III>II, STD aVL>I, STD V3/ STE III close to I, STD V3, V2, SR ratio in AVL (1.5:.5). So most likely inferior wall MI with the RCA being the culprit artery (likely distal). Nice strip
placed on monitor en route to ed??? thanks for playing. leave your gear at the door and go home.
i agree….inferior wall myocardial infarction\