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Additionally, we had to go to a high risk OBGYN for an additional ultrasound to make sure Austin’s heart chambers developed properly (everything appeared OK at the time). When the day came that it was time to say goodbye to Austin, the doctors and nurses were right next to us every step of the way.
In the evening, a middle-aged man complained of chest pain at the nursing home. Nurses found him with a BP of 50/30 and heart rate of 130 and called EMS. Here was his prehospital ECG, which I viewed immediately while the resident performed cardiac ultrasound: What do you think? He was awake, with a pulse of 130 and BP of 50/30.
Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. It would be difficult to get a nurse to give it faster! He was managed medically with Clopidogrel. Medics stated that he had not been taking his clopidogrel for 2 weeks. He appeared to be in shock. See below.
CT angiogram chest: no aortic dissection or pulmonary embolism. Serial chest xrays: progressive bilateral pulmonary edema. Beware a negative Bedside ultrasound. No further troponins were measured. This gets drilled into them. Chest Pain in a Male in his 20's; Inferior ST elevation: Inferior lead "early repol" diagnosed.
On arrival in the ED, a bedside ultrasound showed poor LV function (as predicted by the Queen of Hearts) with diffuse B-lines. Chest X-ray also showed pulmonary edema. Primary VF in this study refers to fibrillation occurring in the absence of shock or pulmonary edema. Initial BP was 120/96, HR 102, SpO2 98%. Potassium was 4.5
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