EMS is called to the parking lot of a local fast food restaurant for a 66 year old male complaining of chest pain.
On arrival, the patient appears acutely ill. His skin is pale/ashen but dry. He is rubbing his chest and there is a grimace on his face. He is not conversant but he answers simple questions with yes or no answers and seems quite content to jump on the gurney and go to the hospital.
Onset: 30 minutes prior to EMS arrival
Provoke: Nothing makes the pain better or worse
Quality: He describes the pain as “crushing” in the center of his chest
Radiate: The pain does not radiate to the arms, back, neck or jaw
Severity: The patient gives the pain a 10/10
Time: No previous similar episodes
Vital signs are assessed.
SpO2: 97 on RA
He admits to mild dyspnea but breath sounds are clear bilaterally.
The cardiac monitor is attached.
*** UPDATE ***
Here is the 12-lead ECG that was captured on arrival at the hospital.