51M presenting to ER. W/ epigastric burning-stabbing discomf | Figure 1

MSarto

Registered Nurse

51M presenting to ER. W/ epigastric burning-stabbing discomfort which awoke pt since 1hr ago. PMHx: DMII, HTN, ETOH abuse, chronic pancreatitis. Pt states discomfort appears to be similar to previous pancreatitis attacks. W/U and treated as A-on-C pancreatitis. Initial HS trop I(-) <10, and EKG done (fig#1). Still remained in slight pain post dilaudid. Fig#2 1min later, and Fig#3 4min later. (I had finished my shift at this point) trop (+) 681, 60min post initial trop. VSS, afeb. Amylase/lipase critically high. What is your management? What's going on here? Fig#4 is an EKG from 3months ago.

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