I received an excellent question this week from a reader who chooses to remain anonymous.
Before we get to his question (and my answer) let’s take a look at the case that prompted the question.
EMS is called to the residence of a 37 year old male c/o “light-headedness”.
Upon EMS arrival the patient is found lying supine on a bench. He is still “light-headed”, appears diaphoretic and also complains of “chills”.
Editor’s side-note: I hope this would be enough for anyone reading this to perform a 12-lead ECG, regardless of the medical history.
The patient denies shortness of breath or chest pain/discomfort.
The patient admits to some nausea but has not vomited.
No feelings of arm heaviness or tingling.
Past medical history is significant for MI x2 years ago which required a stent being placed.
Disturbingly, the patient reports that today’s symptoms remind him of the symptoms he experienced 2 years prior.
Vital signs are assessed.
HR: 92 R
SpO2: 100 RA
Breath sounds are clear bilaterally.
A 12-lead ECG is captured.
A second 12-lead ECG is captured en route to the hospital.
What is your impression?