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A 50-something male with hypertension and 20- to 40-year smoking history presented with 1 week of stuttering chestpain that is worse with exertion, which takes many minutes to resolve after resting and never occurs at rest. At times the pain does go to his left neck. It is a ssociated with mild dyspnea on exertion. Am Heart J.
Sent by Drew Williams, written by Pendell Meyers A man in his 50s with history of hypertension was standing at the bus stop when he developed sudden onset severe pressure-like chestpain radiating to his neck and right arm, associated with dyspnea, diaphoresis, and presyncope. EMS arrived and administered aspirin and nitroglycerin.
There is a patient with persistent chestpain and an initial troponin I over 52 ng/L; 52 ng/L has an approximate 70% PPV for acute type I MI in a chestpain patient. Pain was severe and persistent. CT angiography chest assessing for PE and dissection negative. Heparin drip was initiated. Normal RV function.
He had suffered a couple bouts of typical chestpain in the last 24 hours. This ECG (ECG #3) was recorded immediately after the last episode of pain spontaneously resolved. The pain had lasted about one hour. Case A 40-something male presented to triage. There are classic Wellens' waves in V2-V5. Am Heart J. Am Heart J.
He reports significant chestpain at the base of his scapula on the right side along with new shortness of breath. Wellen's waves indicate that, when the patient was having chestpain, there was occlusion. See these casese (and I have many others): First ED ECG is Wellens' (pain free). A 70-something y.o.
This male in his 40's had been having intermittent chestpain for one week. He awoke from sleep with crushing central chestpain and called ems. EMS recorded a 12-lead, then gave 2 sublingual nitros with complete relief of pain. Type B waves are deeper and symmetric. Am Heart J (1989) 117 : pp 657-665. de Zwaan C.,
We present a complex case of NSTEMI with multi-vessel coronary artery disease treated with PCI via the Carlino technique.Case Description:A 60-year-old female with a history of hypertension, diabetes mellitus, and ischemic heart disease presented with severe chestpain that radiated to the neck and was associated with nausea and vomiting.
This has been termed a “STEMI equivalent” and included in STEMI guidelines, suggesting this patient should receive dual anti-platelets, heparin and immediate cath lab activation–or thrombolysis in centres where cath lab is not available. 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. Anything more on history?
link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chestpain. He described it as "10/10" intensity, radiating across his chest from right to left.
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