77yoM Chest pain | Figure 1

MatthewEMS

EMT

Case Summary

77yoM calls EMS for central chest pain that started at rest 4 hours prior. Initially 10/10 but down to 5/10 on EMS arrival, after taking 2x his own isordil.

Patient known with HPT, IHD, previous MI>10 years prior and NIDDM, reportedly compliant on all meds.

BP initially 210/125 and down to 145/90 by hospital arrival.

No other symptoms, pain worsened on exertion.

Your interpretation of the ECG please?

Related Cases

1. 83 yr old female complaining of 9/10 central chest pain radiating to right shoulder with nausea and vomiting. Pt stated the pain had started going down left arm prior to arrival on scene. Pt had an ashen appearance and look extremely ill.

2. Left hip dislocation after she was using her left leg to scratch her right. CSMs intact upon arrival. Received 150mcg by EMS prior to arrival but pain still 10/10.

3. EMS 12 lead 79 year old male. Sudden onset of crushing chest pain rated 10/10 while at rest. Pale cool and clammy.

4. 65 yo female presents to the ED by EMS with a sudden onset of chest pain that started 2 hours prior to arrival.

Additional Cases

1. 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.

2. A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back.

3. A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days.

4. Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family.