64 y.o. Female with CP – “And then I gave her a NTG…”

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My apologies for the faded ECGs. Turns out the medic (a recent grad from our hospital’s program) had been carrying them in his work pants for over a week, waiting to catch me in the ED. The  patient had been brought to another hospital, but he wanted to review the ECGs with me. They had […]

Conclusion to 80 Year Old Male: Fall

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This is the conclusion to 80 Year Old Male: Fall. If you do not remember the particulars, check out the original post and then come back here to find the “answer” and summary. Case Review You arrived on scene to meet an 80 year old patient who was found on the floor after suffering what […]

“Bad heartburn” – Conclusion

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Recap In “Bad Heartburn” – 82 y.o. female without chest pain, the paramedic had obtained an ECG on an elderly woman who only complained of mild “heartburn.” An initial ECG was obtained: ECG interpretation : The degree of ST elevation is significantly higher in lead II than lead II, which usually supports an RCA occlusion. […]

“Bad heartburn” – 82 y.o. female without chest pain.

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This case is courtesy of paramedic Jason Cameron, who works for Stratford EMS in Connecticut. The ALS unit had been dispatched for an older female with “chest pain.” Upon arrival, however, the 80 y.o. patient denied any pain or pressure, and only endorsed some mild “heartburn,” localized to the epigastrium, non-radiating, and rated it at […]

Conclusion: 38 Year Old Male – Chest Pain and Leg Paralysis.

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Recap In the post yesterday , the paramedic crew was evaluating a 38 y.o. male who had sudden, severe chest pain, as well as leg numbness and paralysis, and whose vital signs showed a mild bradycardia and pronounced hypertension. The ECG obtained by EMS appears to be junctional, with an unclear contribution from the SA […]

38 Year Old Male – Chest Pain and Leg Paralysis.

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You are called for severe chest pain. The patient is a 38 year old male who describes the abrupt onset of a severe pain in his chest about 30 minutes before his wife called EMS. While sweat streams off his face, he tells you that he has never felt pain this intense. He isn’t sure […]

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 […]

80 Year Old Male: Fall

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A previously well 80-year-old experienced a fall at his home where he lives alone. He was walking from the living room to the kitchen when suddenly he found himself on the ground, which he attributes to tripping on the runner rug in the hallway. “My son has been telling me to get rid of that […]

Dont let your bradycardic patient D.I.E.

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At the risk of plagiarizing myself, I’d like to revisit a topic that I discussed on my personal blog a couple of years ago. The story goes that I am not very good with mnemonics. For me they are almost never useful in clinical practice, and as the patient gets sicker my chances of properly […]

45 year old male with “numb hands” – Discussion

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Go back to 45 year old male with “numb hands” to read about the presentation, and see the ECGs.   The culprit artery? After arriving at the hospital, the patient bypassed the ED, going directly to the cardiac catheterization lab. The patient was found to have a total occlusion of the proximal RCA, and the […]

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