Here’s a cool case from a faithful reader named Mike M.
EMS is called to evaluate a 79 year old female with a chief complaint of chest pain.
- Onset: Sudden while watching TV
- Provoke: Nothing makes the pain better or worse
- Quality: “Heavy”
- Radiate: The pain does not radiate
- Severity: 7/10
- Time: About 30 minutes prior to 9-1-1 call
On EMS arrival the patient is alert and oriented to person, place and time, speaking in full sentences.
Skin is cool, pale and diaphoretic.
- Past medical history: Breast CA, Parkinsons
- Medications: Unknown
- No known drug or environmental allergies.
Vital signs are assessed.
- RR: 20
- Pulse: 72
- BP: 152/84
- SpO2: 98 on RA
Breath sounds are clear bilaterally.
No JVD or pitting edema.
The cardiac monitor is attached.
A 12-lead ECG is captured.
What do you think is going on?
How would you treat the patient and why?