EMS is called to the residence of a 71 year old male with a chief complaint of chest discomfort.
On arrival patient is found standing at the front door.
He appears anxious and acutely ill.
Skin is cool, pale and diaphoretic.
Onset: “Fairly sudden” 30 minutes prior to 9-1-1 call
Provoke: Nothing makes the pain better or worse
Quality: Pressure in the center of the chest
Radiate: When asked if the pain radiates the patient states “I don’t know”
Time: Less severe episode yesterday lasting approx 15-30 minutes
Past medical history: Dyslipidemia, mild HTN
Meds: Zocor, Norvasc
Vital signs are assessed.
Pulse: 64 R
SpO2: 98 on RA
Patient admits to mild dyspnea but breath sounds are clear bilaterally.
No JVD or pitting edema.
Oxygen is applied via NRB mask @ 15 LPM.
The cardiac monitor is attached.
A 12-lead ECG is captured.
The patient is loaded for transport and another 12-lead ECG is captured.
What is your impression of these ECGs?
What is your treatment plan?