Today we have a short "Snapshot" case…Just the down and dirty.
You are called to an urgent care center for a 64 year old male, CC of substernal chest pain, which radiated to the right shoulder and neck area. He states the discomfort feels a little like "indigestion".
This episode began just after finishing a 30 minute workout on the bike.
He denies any SOB or lightheadedness, but does admit to becoming diaphoretic. However, he does not know how much of that to attribute to the workout.
Frightened, the patient drives himself to the local urgent care center .
Upon your arrival, the patient states that the discomfort had "just diminished", and that he now "doesn't feel too bad at all".
Vitals are within normal limits, and the patient does not admit to any significant history.
You acquire the following 12 lead:
What are your interpretations of this ECG? How concerned, if at all, are you?
The patient's discomfort has "diminished" by the time you arrive. How does this change affect your assessment and risk stratification of this patient?
You are 15 minutes from the local ED, and 40 minutes from a PCI center, although aviation may be available. How do you want to treat this patient?