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Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing criticalcare. Echocardiogram showed LVEF 66% with normal wall motion and normal diastolic function. He did not remember whether he had experienced any chestpain. Two subsequent troponins were down trending.
Colin is an emergency medicine resident beginning his criticalcare fellowship in the summer with a strong interest in the role of ECG in criticalcare and OMI. They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chestpain. Edits by Willy Frick.
This EKG was recorded as part of a standing order for criticalcare. Upon questioning patient, he denies having any chestpain or chest tightness of any sort. In the absence of chestpain and negative troponin , it appears less likely that he is having acute coronary syndrome though EKG appears concerning.
He reports significant chestpain at the base of his scapula on the right side along with new shortness of breath. First troponin I returns at 48 ng/L ECG 5 143 min No significant change ECG 6 261 min Same hs Troponin I profile (peaked at 1849): Formal Echocardiogram SUMMARY The estimated left ventricular ejection fraction is 74 %.
This 54 year old patient with a history of kidney transplant with poor transplant function had been vomiting all day when at 10 PM he developed severe substernal crushing chestpain. He presented to the Emergency Department with a blood pressure of 111/66 and a pulse of 117. He had this ECG recorded. Troponins peaked at 0.275 ng/ml.
This middle aged male with h/o GERD but also h/o stents presented to the ED with chestpain. The initial troponin I returned at 1500 ng/L and another ECG was recorded as the patient complained of 9/10 chestpain at 10 hours after the first Now the T-wave in III is fully upright, suggesting re-occlusion.
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