Solid case. 70s male started having 10/10 chest pressure whi | Figure 1

Case Summary

Solid case. 70s male started having 10/10 chest pressure while sitting down. Half hour until our arrival and in the mean time he took ASA and 2 sprays of nitro. First 12 lead was 5 minutes after our arrival and the 15 lead was about a minute after that. Nothing from us to slow the rate down. Last 12 lead was just prior to departure. History of a completely blocked coronary artery with no stent and from these EKGs it appears to be RCA. Thoughts?

Additional Cases

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 looked 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.

62 yo male called for vomiting x4 hours. Dialysis pt scheduled for treatment the next morning. New complaint of respiratory distress minutes after we arrived. Within minutes he had audible rales and intense difficulty breathing. Pt. stated CPAP helped immensely. This is his 12 lead, a little messy due to pt movement.

44 yo male CP. V-fib arrest two minutes after this 12-lead. Shocked once back into sinus rhythm. Was talking and alert shortly after that. #cardiac #inferior #infarction

EKG from a witnessed MI, left 12-lead is at first contact with patient, right is 20 minutes later.

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?