EMS is called to the residence of a 66 year old female who was awoken from sleep with substernal chest pressure.
On EMS arrival the patient is found sitting on the edge of the bed.
She appears anxious and exhausted. Skin is pale and clammy.
Past medical history: Breast CA x5 years ago. Additionally, she has recently experienced the death of a spouse and has been suffering from anxiety and insomnia.
Medications: Paxil, Ambien
- Onset: 20 minutes prior to 9-1-1 call
- Provoke: Nothing makes the pain better or worse
- Quality: Pressure also described as a “heaviness”
- Radiate: The pain does not radiate
- Severity: 6/10
- Time: No previous episodes
Vital signs are assessed.
- Pulse: 64
- RR: 18
- NIBP: 138/79
- SpO2: 98 on RA
Breath sounds: clear bilaterally
No JVD or pitting edema.
A 12-lead ECG is captured.
The ECG is transmitted to the emergency department.
Should they activate the cardiac cath lab?