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No ChestPain, but somnolent. The fact that this is syncope makes give it a far lower pretest probability than chestpain, but it was really more than syncope, as the patient actually underwent CPR and had hypotension on arrival of EMS. The American Journal of Emergency Medicine 2015; 33(6):786-790.
Sent by anonymous, written by Pendell Meyers A man in his 50s with no prior known medical history presented to the Emergency Department with severe intermittent chestpain. He denied any lightheadedness, shortness of breath, vomiting, or abdominal pain. Isn't it amazing?? Pol Arch Intern Med. 2017;127:401–411. Circulation.
Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chestpain. American Heart Journal 170(6):1255-1264; December 2015. Triage ECG: What do you think? This is diagnostic of proximal LAD occlusion.
A 70-year-old man calls 911 after experiencing sudden, severe chestpain. Electrocardiographic Manifestations: Acute posterior wall myocardialinfarction. Posterior myocardialinfarction: the dark side of the moon. This case comes from Sam Ghali ( @EM_RESUS ). Thanks, Sam! J Emerg Med 2001; 20:391-401.
Written by Jesse McLaren, with comments from Smith and Grauer A 60 year old presented with three weeks of intermittent non-exertional chestpain without associated symptoms. A prospective validation of the HEART score for chestpain patients at the emergency department. Lancet 2015 6. Int J Cardiol 2013 2.
Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chestpain onset around 9 PM the evening prior. The following ECG was obtained.
A 50-something male who is healthy and active with no previous medical history presented with 5 hours of continuous worrisome chestpain. Chestpain with New LBBB: It helps to actually measure the ST/S ratio A Fascinating Demonstration of ST/S Ratio in LBBB and Resolving LAD Ischemia The cath lab was activated.
Written by Pendell Meyers, edits by Smith and Grauer A man in his late 20s with history of asthma presented to the ED with a transient episode of chestpain and shortness of breath after finishing a 4-mile run. His symptoms of chestpain and shortness of breath were attributed to an asthma exacerbation during exercise.
== MY Comment by K EN G RAUER, MD ( 9/17/2020 ): == Todays patient is a previously healthy, 60-something year-old woman who presented with chestpain that began at a reception. Smith for developing Modified Smith-Sgarbossa Criteria for assessing ST-T wave changes in chestpain patients with LBBB. See text ). (
Introduction:Over 6 million patients (pts) present to US emergency departments annually with chestpain (CP), of which the majority are found to have no serious disease. Evaluation of these pts results in substantial costs for unnecessary hospitalization and extensive testing. Length of stay (LOS) in the CPU to discharge was 10.4
Cardiology felt her chestpain to be, most likely, the result of coronary supply-demand mismatch in the context of HCM endothelial remodeling (i.e. New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardialinfarction in the emergency department. Below are two examples of this.
It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chestpain, weakness and nausea. myocardialinfarction), arrhythmias, valvular pathology, shunts, or outflow obstructions. 2015 Oct; 66(4):355-362. Annals of Emergency Medicine.
Check : [vitals, SOB, ChestPain, Ultrasound] If the patient has Abdominal Pain, ChestPain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Old myocardialinfarction, 6. to 1.45) for fatal or nonfatal stroke.
He contacted EMS due to acute onset chestpain and feeling unwell and fatigued. He subsequently developed worsening chestpain. This, in the context of worsening chestpain , is evidence of reocclusion of the infarct-related artery and active OMI in development. The below ECG was recorded.
Case A 76 year old man with chronic hypertension but no history of coronary disease or myocardialinfarction presented to the ED with chestpain at 2343. It is awaiting FDA approval (but approved for 1.5 The Queen of Hearts recognizes this as OMI ("STEMI/STEMI Equivalent").
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