Terrormedic

Case Details

65 yo male with pmh of HTN and 1ppd smoker presents to clinic with cx pressure upon exertion x2 wks that was 8/10 at time of clinic visit with SOB prompting him to come in. MD sees changes in ekg (picture 1 from 4 months prior and picture 2 from visit) and calls 911. Upon contact pt had no complaints and ekg was obtained (pic 3 and 4). 199/108. HR 64 and reg. RR 16 non labored. Spo2 100%. Skin normal. 0/10 pain. What do you see?

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Dispatched to a residential address for a 64 y/o female with chest pain. On arrival found pt CA&Ox4 cool pale and diaphoretic. Complaining of 8/10 "squeezing" sensation in their chest and mild SOB. The pt had been seen for the chest discomfort at an urgent care roughly 10 hours before where they were advised to go to the ED but left AMA. EKG 1 taken in the pts house. EKG 2 taken roughly 5 min later after they were extricated. EKG 3 (not shown) had no change. EKG 4 was a posterior done en route to the hospital. EKG 5 Right sides done en route. EKG 6 done as we arrived at the hospital. Pt denied PMH, meds, or allergies. Pts EKG from that AM showed upright T waves and no STD in V1-3. Pre hospital notification was made. IV started, ASA given. Pt to cath lab on arrival.

74yo male went to his local urgent care for chest pain. MD did EKG and contacted our hospital. Patient flown directly from urgent care to us. EKG above taken upon arrival to ED and showed significantly more elevation than one taken at urgent care. Pt changed, lined, and labbed as prep for cath lab. Door to cath lab time: 7 minutes. Patients trops trended s/p cath and maxed out our readings at ">200". Today they came down to 70. Sorry for the poor picture quality.

30yo male comes for first visit at family doctor at a new clinic. Declares not to use drugs or smoke. BP 108/72 85bpm. No relevant findings in standard blood screening. EKG fins abnormal T wave and TP interval. Not known previous EKG. No family history of cardiac diseases. Diagnosis?

Quick game! Should be an easy one given the last year. 55 year old male visits urgent care CC abdominal pain, headache, fatigue. No known contact/exposures and unvaccinated. Reports hx of arthritis otherwise no other hx etc. Pt presents to clinic with SPO2 reportedly in 60s. Clinic administers Duoneb x 1 and administers O2 via NC @ 4 LPM. Obtains CXR (shown). Pt ambulated into ambulance upon arrival, and corroborates hpi provided by provider but also endorses shortness of breath and a cough producing rust colored sputum, LS minimally diminished left side with faint crackles in left base otherwise clear equal and good aeration. GCS 15, silent tachypnea. Rest of exam unremarkable. Initial SPO2 shown. What’s the spot dx!? What is this specific presentation/patient called? Treatment options? Students first!

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.

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?