Here’s a very interesting case submitted by FF/medic Tim Porter (c/o a faithful reader).
The patient is a 56 year old male with a chief complaint of chest pain.
Onset: Approximately 30 minutes prior to EMS arrival
Provoke: Nothing makes the pain better or worse
Quality: Described as intense pressure
Radiate: The pain does not radiate to the arms, back, neck, or jaw
Time: Unknown whether the patient has experienced previous similar episodes
The patient denies shortness of breath.
The patient’s skin is pink, warm, and dry.
Past medical history is significant for cardiac stent 2 years prior.
Vital signs are assessed:
SpO2: 97 on RA
A 12-lead ECG is captured.
- Prior history
In this case, the patient only had prior history.
So, what is your impression?
More to follow…
*** UPDATE ***
Some interesting comments so far. To help illustrate the changes in the right precordial leads between 12-lead 2 and 12-lead 3, I created a side-by-side comparison.
Take a look and share your thoughts!
*** UPDATE #2 ***
Here’s the 12-lead ECG that should remove all doubt about what’s going on here!