STEMI Mimics and STEMI Equivalents

Here’s my presentation from the VA EMS Symposium on 11/08/2013.

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
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Brooks Walsh MD
“Bad heartburn” – 82 y.o. female without chest pain.
Any thoughts on the case?
2014-08-20 19:08:29
Daniel
“Bad heartburn” – 82 y.o. female without chest pain.
We are lucky in my area to have a "Code 37" alert (STEMI alert) that puts the cath team into action. I would call a "Code 37" due to inferior STEMI, then a right sided ECG to look for right ventricular involvement prior to NTG administration for treatment decision reasons, then do a posterior 12-lead…
2014-08-20 19:05:40
Razvan A.
“Bad heartburn” – 82 y.o. female without chest pain.
Inferior STEMI (ST Elevations in DII, DIII, aVF) ST Depression in V1-V4 I would do posterior and right derivations. 325mg aspirin, 600mg clopidogrel. I would withheld NTG due to the low HR and the possibility of RVI. (RVI is preload dependent, remember?) If pain increases I would administer a small dosage of Fentanyl to relieve…
2014-08-20 19:04:06
burned-out medic
“Bad heartburn” – 82 y.o. female without chest pain.
potatoes, potatoes. heartburn, pain.
2014-08-20 18:51:08
Brooks Walsh MD
“Bad heartburn” – 82 y.o. female without chest pain.
Sorry for the confusion - the patient has switched gender a few times during writing!
2014-08-20 18:49:10

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