53 YOF with AMS: STEMI or Secondary ST-T Changes?

This is the case of a 53 year old female who presented to the Emergency Department (ED) via EMS, with Altered Mental Status (AMS).

EMS was called to a local dialysis center due to the patient being unresponsive after approximately 3 hours of dialysis.

Upon arrival to the ED, the patient was unable to answer questions, with a Glasgow Coma Scale (GCS) of 8 and the following baseline vital sings:

  • Heart Rate: 74 beats/min, strong and regular

  • Respiratory Rate: 15 breaths/min, adequate tidal volume and regular, with clear sounds

  • Non-invasive Blood Pressure: 202/76 mmHg

  • SpO2: 99% on 15 LPM via Non-rebreather

  • Pupils: 3 mm and reactive to light

  • Blood Glucose Level: 68 mg/dL

Known Medical History:

  • Hypertension (HTN)

  • Chronic Renal Failure

No know allergies.

The following 12 lead ECG was obtained by EMS prior arrival to the ED:

lvh osceola web

(Click on the ECG for a full view)

  • What is your detailed ECG interpretation?
  • What is your treatment?

Click HERE  for the conclusion:

 

 

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EMS 12-Lead

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Comments
Ivan Rios
The role of 12 lead ECG in Pediatric Pulmonary Hypertension
Thanks for writing Tyler. They are the same thing. Strain pattern is just the result of increased pressures against the ventricles which alters the way repolarization occurs from epicardium to endocardium. Similar to stepping on a puddle of water. Your show spreads the water away from the area of pressure. The ST segment is slightly…
2014-12-17 18:44:24
Tyler
The role of 12 lead ECG in Pediatric Pulmonary Hypertension
Can you explain how these ST segment and T wave changes can be differentiated from right strain pattern?
2014-12-17 18:18:25
The role of 12 lead ECG in Pediatric Pulmonary Hypertension | EMS 12 Lead
PULMONARY PRESSURES AND ECG PATTERNS
[…] Pulmonary artery pressures and ECG patterns […]
2014-12-17 17:34:06
EMS 12 Lead
PULMONARY PRESSURES AND ECG PATTERNS
[…] Pulmonary artery pressures and ECG patterns […]
2014-12-17 17:26:42
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[…] http://www.ems12lead.com/2014/11/11/sudden-cardiac-arrest/ November 11, 2014 | Original Articles | Vince […]
2014-12-16 16:08:39

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