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Post by jpollock on Oct 13, 2015 10:31:56 GMT -5
This patient had a history of GERD and high cholesterol, had been having intermittent left chest and shoulder pain which radiates to the back since last night. father had MI in his 40s. Pt also reports some diaphoresis earlier. He is a smoker. He receives asa and nitrox2 without significant change in symptoms. He appears in no distress, non diaphoretic with unremarkable exam. here is his EKG  |
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Post by jpollock on Oct 13, 2015 10:35:41 GMT -5
any thoughts?
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Post by Bjs04f on Oct 13, 2015 20:37:53 GMT -5
I and AVL have ST depression and min St elevation in inferior leads. Welcome to the hospital stress time
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Post by jpollock on Oct 14, 2015 9:27:10 GMT -5
that was the plan, then he became diaphoretic and worsening chest pain. We repeated the EKG 
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Post by Bjs04f on Oct 14, 2015 12:37:33 GMT -5
call STEMI, inferior, with his symptoms
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Post by jpollock on Oct 16, 2015 10:04:04 GMT -5
That's what we did. Ended up with a R sided stent for 90% blockage
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Post by tyson on Oct 21, 2015 12:19:08 GMT -5
Read this on Steve Smith's ECG blog site, kind of mind boggling:
Learning Point:
Millimeter criteria are dangerously insensitive for acute myocardial infarction (sensitivity 48%!), though better for acute coronary occlusion (around 70%). If you rely on them, you will miss approximately 25-30% of acute occlusions.
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