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Conclusion to 43 year old female CC: Chest pain – Angiograms

4 comments

Here is the conclusion to 43 year old female CC: Chest pain.

Let’s take another look at her 12-lead ECG.

This patient experienced cardiac arrest on arrival in the emergency department.

She was defibrillated while still on the EMS gurney, stabilized, and then transferred to the cardiac catheterization lab.

Here we see a proximal occlusion of the right coronary artery (RCA). Those of you who suspected right ventricular infarction in addition to acute inferior STEMI were exactly correct.

Here we see the wire crossing the lesion.

Balloon inflation.

More balloon inflation.

Blood flow restored.

The patient was admitted to the ICU and discharged three days later.

Diagnosis: ST-elevation myocardial infarction

Posted by on November 20, 2010 • Filed under: ems-topics, patient-management • Tagged: , , , , ,

4 Comments

  1. Patrick says

    It’s always good to hear a happy ending.

    on November 21, 2010 @ 3:44 am.
  2. just another medic says

    I had a patient who presented with back pain with a nearly identical 12 lead, right ventricular infarction, and inferior infarct. Story was the same, down to coding upon arrival and a good outcome.

    Thanks for the post! (And the excellent blog, I’ve learned a lot.)

    on November 22, 2010 @ 5:50 pm.
  3. just another medic says

    Now that I think about it, wouldn’t the depression in V2-6 be reciprocal to posterior elevation? Was a posterior 12-lead captured?

    I would also be curious as to the prehospital treatment of this patient (nitrates given? fluid bolus?)

    on November 23, 2010 @ 7:54 am.

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