68 YOM no prior cardiac history.
Reports severe L arm, shoulder, and jaw pain for 6+ hours.
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90+ year old complaining of shoulder pain. For EMS'ers. What's the score here?
female pt self presented @ GP with crushing chest pain, shoulder pain, nausea n diaphoresis. Initial GP 12 lead was normal - nil changes. Our 12 lead (photo 1) shows Inferior STEMI, rapid evolvement over 10mins. Photo 2 is Resus photo approx 10 mins later. Straight to Cath lab.
86M w/ Afib (eliquis) presents to ER with discomfort to Lt shoulder ever since he woke up. Pain remains constant and sharp, with increased tenderness and discomfort w/ movement. During ambulance ride pain increased when riding over the bumps. On assessment pt states that shoulder was sensitive to touch and pain diffused downwards to extremity. No weakness or paresthesia. EKG was obtained as a precautionary measure. Should I be worried? How should I treat this case? What's my next step? Thoughts
84 YOF called 911 due to having chest pressure for approximately 45 minutes. Patient described the pressure as substernal, constant, and heavy with a pain scale of 7/10. Appear to be in no distress, S/S PWD, normal work of breathing. Denied: dizziness, headache, neck/jaw/shoulder pain, radiation of chest pain, SOB, back pain, N/V/D, extremity pain/tingling/numbness/edema, recent illnesses. Stated she felt this pain the night prior, but it shortly relieved after taking an aspirin. This ECG is a limited right-sided 12 lead (V4=V4R). STEMI alert given to the closest PCI capable facility, ECG transmitted to ED via WiFi, cardiologist met with the patient at bedside upon arrival, patient taken straight to cath lab. I don’t have any results from cath lab yet, I’ll post more when I find out.
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A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.
A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.
A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.
70 yo WF with 20y hx HTN lost 21 lbs on a semaglutide but still BMI over 30, shows drop in BP when standing, stabilizing at 102-116 systolic, 65-75 diastolic. Discontinued all HTN meds x 30 days and no episodes of HTN. Could a small weight loss like this cause a drop to normal BP? Has anyone heard of a side effect of lowering BP?