Here’s a really interesting ECG submitted by my good friend David Hildebrandt.
EMS is called to an assisted living facility for an 88 year old female who is weak and complaining of chest pain.
The patient is found lying on her side in bed.
She appears acutely ill and states she is nauseated.
She is oriented to first and last name and place, but not the day of the week. However, she knows it is 2011 and that Obama is the POTUS.
Past medical history: HTN, CHF, CVA x 4 years ago, osteoporosis, L hip replacement
Medications: Lopressor, Capoten, Lasix
Skin is cool and clammy.
2/4 pitting edema is noted in both ankles which the CNA states is normal for her.
Breath sounds: mostly clear (slight rales)
Vital signs are assessed:
SpO2: 96 on RA
The cardiac monitor is attached and shows sinus rhythm.
A 12-lead ECG is captured.
What is your impression of this ECG?
How would you treat this patient?