81 year old male CC: "Cold and shaky" – Conclusion

Here is the update to 81 year old male CC: “Cold and shaky”

The patient was sent to the cardiac cath lab where angiography revealed 100% occlusion of the right coronary artery (RCA). A stent was successfully placed and the patient is doing well.

Before

Balloon inflation

After successful stent placement

Diagnosis: Acute Inferior ST-Elevation Myocardial Infarction

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EMS 12-Lead

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Comments
Tim
The most awesome STEMI test on the internet!
Thanks for the app. It made me think about all that one may see in the field. The only problem was I never got a score or saw the results of how I did other than saying I had completed the test. Anyway a great way to get the old brain working.
2014-10-30 13:14:27
Brian
83 Year Old Male: Shortness of Breath
I mostly agree with dustin. I believe this is may be an isolated posterior MI. The R wave in V2 points to it being a posterior MI. otherwise it is a 1st degree av block with a LAHB. I am somewhat concerned with the concordant t segment depression noted and in fact if you were…
2014-10-30 04:22:44
Karl Brennan
Understanding Amiodarone
Great article , however in VF caused by hyperkalemia it should be avoided along with lidocaine , Since it shuts down the K channels, the eiteiology of the arrest hyper K, K channels are needed to exchange K in the cell. Calcium , Bicarbonate, dextrose and insulin should be used to decrease K levels along…
2014-10-30 03:04:45
Dustin
83 Year Old Male: Shortness of Breath
I see a very sick and complicated patient. 12 Lead: ST elevation in AVR and V1 along with depression in I, II, V4-V6 leading me to an LMCA occlusion. The tall R wave in V2 also points me to Posterior involvement. Posterior MIs and LMCA occlusions can and do cause pulmonary edema, which this patient…
2014-10-30 02:38:21
Adrian
83 Year Old Male: Shortness of Breath
Firstly, the patient is septic, he needs high flow O2 (which he's already receiving), IV fluids, blood cultures and antibiotics (most likely IV) and needs to be in resus sharpish. Secondly, the ECG needs doing again, V2 is wrong and I'm not sure where it's been placed to get that reading. Assuming the rest of…
2014-10-30 01:00:42

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