59 Yom cc of chest pain. patient has no major medical histor | Figure 1

59 Yom cc of chest pain. patient has no major medical history. stated that there had been chest pain x3 days but this pain was different. stated this onset of pain started approximately 4 am. patient placed on the monitor and saw elevation right off the get go (I'm a medic student so I'm still learning all of this). I looked at the medic and stated that something didn't look right but was unsure. strip printed and the medic stated get the patient in the truck and go. vitals were stable en route and cath lab met us at the hospital. my medic states that there is no a-fib just artifact. my medic also sated she did a right sided EKG and found that there was right sided involvement. pt was given asprin by a family member. medic administered fentanyl for pain management. pt vitals were 156/92, pulse 78, resp 18 normal non labored, spo2 100 on ra aa4 and gcs 15.

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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. 1st picture is initial 12 lead, 2nd is 15 lead immediately following, and 3rd is rhythm strip sometime en route to ER. Pt went from ER to cath lab.

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Field Medic Mystery Series : 26
A Pulse, A Look, A Diagnosis?
Dispatch: Chest Pain
Patient in her 80s in moderate distress, mildly diaphoretic, complaining of sudden-onset chest pressure. You feel a slow, weak pulse and look at her neck, and from there pretty much know what you are going to see on the monitor.... a fairly solid provisional diagnosis in ten seconds
How did you do that?
(Disclaimer: This series - Field Medic Mystery - is composed of actual patients, true stories. In this case, however, the ECG and the neck photos are two different patients exhibiting the same phenomenon. Actually, the ECG and the pulse I took were from a man in his 50s, but I didn’t get pics of his neck)

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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.

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?