Archive for February2014

74 year old male with chest discomfort, right bundle branch block, and ST-segment elevation

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It’s a sunny winter afternoon when EMS is called to a doctor’s office for “an adult male with possible heart problem.” When you arrive you are led into room #3 where you find a 74 year old male in no apparent distress. His color looks good. You introduce yourself and find out that your patient was […]

Conclusion to Snapshot Case: 44 Year Old Male – Chest Tightness

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This is the conclusion to the Snapshot Case located here. You may want to review the initial description again. As many readers correctly pointed out, this patient is experiencing a STEMI. Let's start with the basics and work our way up to some pretty advanced topics. First, there is anterior ST-elevation with upwardly-concave T-waves, as […]

All that wiggles isn’t Wellens’

This is the discussion for our Snapshot Case involving a 45 year old female complaining of chest pain. Here is the 12 lead for review: There is sinus rhythm at about 75 bpm. Slight ST elevation in V2. Biphasic T wave inversion in V2, inverted T waves in aVL, V3-V5. As we recall, the patient had complained of […]

Snapshot Case: 44 Year Old Male – Chest Tightness

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Here's a new "Snapshot" case courtesy of Dr. Bojana Uzelac from Serbia… A 44 year old male presents with a chief complaint of tightness in his chest x 1 hour. He was on his way to a conference when it started and states: "It feels kind of like asthma. I've never been diagnosed but I […]

CONCLUSION: 87YOM COMPLAINING OF CHEST DISCOMFORT AND DYSPNEA

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This is the conclusion of the previous case: http://ems12lead.com/2014/01/87-yom-complaining-of-chest-pain-and-dyspnea/ So, as mentioned before, you obtain this 12 lead ECG: A few minutes later, the LIFEPAK 15 prints out another 12 lead ECG: Although the computer suggests Atrial fibrillation, this irregular tachycardia has a group beating pattern with presence of P waves prior the QRS complexes and […]