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Written by Jesse McLaren, with edits from Smith and Grauer A 60 year old with no past medical history presented with two hours of chestpain radiating to the left arm, with normal vitals. But it doesn’t meet STEMI criteria, and was not identified by the computer or the over-reading cardiologist. What do you think?
A 90 yo with a history of orthostatic hypotension had a near syncopal event followed by chestpain. Chestpain was resolved upon arrival in the ED. In other words, after reperfusion therapy for STEMI, the appearance of AIVR is usually a good sign, meaning that the artery is reperfused. His previous ECG was normal.
A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chestpain and SOB. She had one episode of pain the previous night and two additional episodes early on morning the morning she presented. Deep breaths are painful and symptoms come and go.
The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chestpain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion.
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