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[link] A 30 year-old woman was brought to the ED with chestpain. It had started just after nursing her newborn, about an hour prior, and she described it as a severe non-pleuritic “pressure” radiating to the back. She had given birth a week ago, and she had similar chestpain during her labor.
After dinner the day of presentation, she had left neck and elbow pain which she described as dull, achy, and worse with exertion. She contacted her neighbor, a nurse, for help. See this case: Persistent ChestPain, an Elevated Troponin, and a Normal ECG. See this case: A man his 50s with chestpain.
Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chestpain similar to his prior MI, but worse. The pain initially started the day prior to presentation. The ST elevation from today is ~0.2
Echocardiogram: Estimated left ventricular ejection fraction, lower limits of normal; 45-50%. In summary — this leaves us with the abrupt onset of a regular WCT rhythm at ~185-190/minute ( that woke this nursing home patient up from a sound sleep ) — without any clear sign of atrial activity.
David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (ret) @DidlakeDW Expert commentary and peer review by Dr. Steve Smith [link] @smithECGBlog A 57 y/o Female with PMHx HTN, HLD, DM, and current use of tobacco products, presented to the ED with chest discomfort. Echocardiogram findings (pre-procedure) 1.
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