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The patient presented due to chestpain that was typical in nature, retrosternal and radiating to the left arm and neck. He denied any exertional chestpain. It is unclear if the patient was pain free at this time. He has a medical hx notable for hypertension, hyperlipidemia and previous tobacco use disorder.
The patient presented with chestpain. I was taught that the tell-tale sign of ischemia vs an electrical abnormality was in the hx, i.e. chestpain for the ischemia and potential syncope for brugada. Only 5-18% of ED patients with chestpain have a myocardial infarction of any kind. Is it Brugada pattern?
Written by Pendell Meyers A man in his 70s with no cardiac history presented with acute weakness, syncope, and fever. He denied chestpain or shortness of breath. In the clinical context of weakness and fever, without chestpain or shortness of breath, the likelihood of Brugada pattern is obviously much higher.
All of the patients presented with chestpain , and they are all in triage. Smith: This bizarre ECG looks like a post cardiacarrest ECG with probable acidosis or hyperkalemia in addition to OMI. Which, if any, of these patients has OMI, with myocardium at risk and need for emergent PCI? What was the pH and K?
It was from a patient with chestpain: Note the obvious Brugada pattern. The elevated troponin was attributed to either type 2 MI or to non-MI acute myocardial injury. There is no further workup at this time. Smith: Here is a case that was just texted to me today from a former resident. This patient ruled out for MI.
J Electrocardiology 45 (2012):433-442. Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiacarrest in sleep. The patient denied any chestpain whatsoever, and a troponin at zero and 2 hours were both undetectable.
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