Cath lab activation? | Figure 1

Paced_and_Confused

•Follow

Registered Nurse

Report case

Cath lab activation?

50’s year old female presents to the ED. Chief complaint of mid/upper epigastric pain. She states she feels like something is “stuck” under her rib on the left side. Pain is unrelieved by position change. She is A/ox4, in no obvious signs of immediate distress. She denies N&V or SOB. Based on the first and second ekg are you activating the cath lab? Labs and story to follow after a few answers about the EKG are posted.

The author made an update to this case

Update 1

First trop came back at 5100. Patient had a brief run of polymorphic VT. Shocked once with several compressions. Cath lab finally activated. 99% mid LAD stenosis found.

Diagnosis Added

ACUTE MI

More about this case

ResolvedTrending

Why you should join Figure 1

Similar cases

\
These are sequential EKGs of a patient with pressurising chest pain and history of an NSTEMI. It is obvious from ECG 2 that the patient needs no more EKGs (!) and must be in cath lab. Trop also rising exponentially.](https://app.figure1.com/case-detail/18c48d61-c760-4f6d-a3b2-64aa07babb13)

\
69 year old female who comes to our ER with history of 3 days of opresive substernal chest pain at rest, it gets worst when she lies down and gets better when she sits. PMHx HTA, CKD with #Peritoneal-dialysis. EKG sinus rhythim with ST elevation in inferior wall and lateral and depresikn of the PR generalized. Cardiac Markers negative, she is admitedd to the Semi ICU Pic 1 EKG at arrival to the ER, Pic 2 EKG 2h post first](https://app.figure1.com/case-detail/20846979-8e40-43be-bc43-5a8b2174b7ac)

\
73yo/f presents to the ED with a CC of hyper K. Per her primary care she had her labs drawn earlier in the day. The patients K came back as 6.3. She is complaining of minor SOB on exertion but denies chest pain. What should our hyper K treatment be? What hyper K changes do we see on this ekg if any?](https://app.figure1.com/case-detail/7e2cbdf8-4f5d-4c15-8bc7-dda1ff7d8e0f)

Trending now

\
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.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)

\
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.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)

\
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.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)

\
patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)