EMS is called to the doctor’s office to evaluate a 54 year old male complaining of chest pain.
On arrival, the patient is alert and oriented to person, place, time, and event. However, he is anxious and his skin is pale and diaphoretic.
He is on oxygen via NC @ 4 LPM. An IV has been started and is running KVO. The patient has been giving 4 baby aspirin and administered 1 SL NTG spray prior to your arrival.
Onset: 2 hours ago while at work
Provoke: Nothing makes the pain better or worse
Quality: Described as a heavy pressure leaving him breathless
Radiate: The pain radiates up to the neck and jaw
Severity: Patient reluctantly gives the pain an 8/10
Time: No previous episodes
Past medical history: Depression, hyperlipidemia
Vital signs are assessed.
SpO2: 99 on RA
The cardiac monitor is attached.
*** UPDATE ***
A serial ECG is obtained en route to the hospital.