Tag Archives: Identifying AMI in the presence of LBBB

An unusual case of left bundle branch block – Discussion

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It turns out this patient was experiencing a STEMI.

80 year old male CC: Chest pain

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Here’s a case submitted by a faithful reader who wishes to remain anonymous. It’s a great case and destined to be one of my favorites! EMS is called to evaluate a 80 year old male patient with a chief complaint of chest pain. On arrival the patient is found sitting on his living room couch. […]

58 year old female CC: Chest pain

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Here’s another case study from an international reader who wishes to remain anonymous. Presenting Complaint – Chest Pain History of Present Complaint – 58 year old female, nil cardiac history, mild smoker, social drinker and overweight. Complaining of acute central chest pain @ rest. Awoken by pain. On Arrival – Sat upright on settee (Editor’s […]

62 year old male CC: Chest pain

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62 year old male presents to the emergency department complaining of chest discomfort. Past medical history is significant for dyslipidemia and ulcerative colitis. Also prior history of significant tobacco use. Maternal history of CAD. Maternal and paternal history of stroke. The patient’s only medication is Lipitor but he took an aspinin en route to the […]

Found on the Lifenet Receiving Station

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Is there anything about this ECG (other than the poor data quality) that interests you? The patient was a 90 year old male, fall with injury. Also complaining of pain between the shoulder blades. *** UPDATE *** This ECG caught my eye because it satisfies one of Sgarbossa’s criteria for the identification of AMI in […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

JEMS Talk: Google Hangout

Comments
darren
79 year old female CC: Chest pain – Conclusion
What concerns me is the total waste of time doing Right sided precordial leads in this case: to what end is this relevant when we already have clear evidence of inferior-Lateral MI. Time wasted doing that I think.
2015-01-31 15:01:35
darren
79 year old female CC: Chest pain – Conclusion
Infero-lateral MI therefore circumflex and not RV wall. Possibly posterior involvement but irrelevant.
2015-01-31 14:58:21
Anne
Adenosine for sinus tachycardia: Try to avoid this!
If it were me, I would seek a second opinion; consult an electrophysiologist. Unlikely that you had sinus tachycardia at that rate.
2015-01-26 09:46:57
John
Adenosine given for a narrow-complex tachycardia over 150
If things such as Sepsis, Drug Use, Medication issues, Anxiety, Pain, etc.. have been ruled out, and the rate is still >160 (or whatever number you use). How else do you determine S-Tach Vs. SVT? Does a 12 Lead Help (QRS Complexes facing different directions due to different pathways etc..) or a simple 4 Lead?…
2015-01-19 19:44:32
Brandon O
Adenosine for sinus tachycardia: Try to avoid this!
She may not have had anxiety, but I bet she was a carrier...
2015-01-18 02:31:08

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