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58 Year Old Male, Workout Worry

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  Your Paramedic crew is called to the home of a 58 year old male, “possible heart” Upon arrival to the home, you are greeted by the gentleman’s wife, who directs you to your patient. You find him sitting in a chair in the living room, appearing concerned, but in no serious distress. He tells […]

71 Year Old Male: Chest Discomfort- Discussion

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Here is the discussion for “71 year old male: chest discomfort” let’s review the prehospital 12 lead:     Here are the precordial leads blown up:   There is slight ST elevation in V1,  ST elevation in V2 (saddleback morphology), as well as slight ST elevation in V3 and V4. The STE in V3 and V4 […]

Rapid Prehospital Evolution of STEMI

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82 year old male, in good physical shape, stops at a cafe for lunch after cycling for an hour. Witnesses report a syncopal episode lasting approximately 30 seconds. Patient history significant for prior MI requiring 3 stents. No other significant history. Patient denies any CP, SOB, N/V, lightheadedness. In fact, he denies any complaints at […]

Snapshot Case- No Day at the Beach

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It is a beautiful summer afternoon when you and your partner are called to the beach for a “swimmer in distress”. Upon your arrival, you find a 48 year old male sitting on a beach towel, appearing to be in some distress. You are told that he was swimming in the ocean when he began […]

57 Year Old Male–Chest Discomfort

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  It is a bright Sunday morning when you and your partner are dispatched for an “adult male-chest pain”. You arrive at a well kept residence, noting a ladder and paint cans as you enter. You find your patient, a 57 year old male, sitting on the sofa in mild distress. “I was doing some […]

Discussion for 70 Year Old Male: Short of Breath

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This is the discussion for “70 Year Old Male: Short of Breath“. Tough case. Lots of excellent comments and observations from our readers. Right off the bat, the patient’s presentation offered a major distraction: the recent eye surgery resulting in the old “eye patch presentation”. Confounding the situation further was the lack of any cardiac […]

70 Year Old Male: Short of Breath

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Good morning sports fans! You are dispatched to the residence of a 70 year old male, complaining of “shortness of breath”. You pull up to a well kept home, and are met at the front door by the patient’s wife. She tells you that her husband came home from the hospital yesterday after cosmetic eye […]

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 […]

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 […]

63 Year Old Female, CC: Neck and Arm Pain–Discussion

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  This is the discussion for our recent case 63 Year Old Female, CC: Neck and Arm Pain. Let's revisit the 12 Lead ECG: There "appears" to be a Sinus Brady rhythm at a rate of about 52 bpm, with a first degree AVB. The rhythm is regular for the first half of the ECG, then […]

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