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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. Code STEMI was activated by the ED physician based on the diagnostic ECG for LAD OMI in ventricular paced rhythm. Limkakeng AT.
So we activated the Cath Lab Angiogram: Impression and Recommendations: Culprit for the patient's anterior ST segment myocardial infarction and out of hospital V-fib cardiac arrest is a thrombotic occlusion of the mid LAD The first troponin returned barely elevated at 36 ng/L (URL = 35) In our study of initial troponin in STEMI, 26.8%
A 50-something man with history only of alcohol abuse and hypertension (not on meds) presented with sudden left chestpain, sharp, radiating down left arm, cramping, that waxes and wanes but never goes completely away. persistent pain despite medical Rx brought emergently to Cath lab." It was not a STEMI) 1.
Written by Jesse McLaren A 65 year old with a history of atrialflutter, CABG and end-stage renal disease on dialysis presented with 3 days of fluctuating chestpain, which was ongoing at triage. So a patient with high pretest probability (prior CABG with new chestpain), had new ECG changes showing posterior OMI.
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