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80 Year Old Female: “Rapid Heart Rate”

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You are dispatched to a nursing home for an 80 year old female with a “rapid heart rate.” You arrive on scene and the charge RN gives you report. Per the RN, assistive staff were checking the patient’s vitals this morning when they noted her heart rate to be elevated. They consulted the RN, who […]

71 Year Old Male: Chest Discomfort- Discussion

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Here is the discussion for “71 year old male: chest discomfort” let’s review the prehospital 12 lead:     Here are the precordial leads blown up:   There is slight ST elevation in V1,  ST elevation in V2 (saddleback morphology), as well as slight ST elevation in V3 and V4. The STE in V3 and V4 […]

71 year old male: Chest Discomfort

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  This very interesting case comes from Bryan F, a Paramedic from Long Island. A 71 year old male is cooking breakfast when he experiences sudden onset of 10/10 chest discomfort. He waits 20 minutes or so for it to subside, but it does not and he calls 911. EMS arrives to find him lying […]

50 Year Old Male: Chest Pain, Hypotension, Pulmonary Edema (Conclusion)

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This is the conclusion to Friday’s post. If you haven’t seen it, I suggest checking out the original patient presentation and ECG first. We have reproduced this case courtesy of Dr. Musa A. Sharkawi (@MusaSharkawi on Twitter). A 50-year-old man presented with sudden-onset chest pain, respiratory distress, pulmonary edema, and hypotension. This was his ECG: […]

50 Year Old Male: Chest Pain, Hypotension, Pulmonary Edema

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Physician and cardiovascular fellow Dr. Musa A. Sharkawi shared this ECG on Twitter (@MusaSharkawi) and has graciously allowed us to reproduce it here. A 50-year-old male presents with a chief complaint of abrupt-onset severe chest pain. He is pale, diaphoretic, and ill-appearing—in moderate respiratory distress with extensive biateral crackles and a low blood pressure. Further […]

Rapid Prehospital Evolution of STEMI

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82 year old male, in good physical shape, stops at a cafe for lunch after cycling for an hour. Witnesses report a syncopal episode lasting approximately 30 seconds. Patient history significant for prior MI requiring 3 stents. No other significant history. Patient denies any CP, SOB, N/V, lightheadedness. In fact, he denies any complaints at […]

Snapshot Case- No Day at the Beach

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It is a beautiful summer afternoon when you and your partner are called to the beach for a “swimmer in distress”. Upon your arrival, you find a 48 year old male sitting on a beach towel, appearing to be in some distress. You are told that he was swimming in the ocean when he began […]

59 Year Old Female: Intermittent Head Pain (Conclusion)

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This is the conclusion to Wednesday’s post; if you haven’t seen it, I highly suggest checking out the original case description and initial ECG. Wednesday’s case introduced a 59 year old woman with a chief complaint of intermittent occipital head pain for about 10 days. Recently, it had started radiating into her neck and upper […]

59 Year Old Female: Intermittent Head Pain

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One of my co-workers told me that she wants to see more case studies. A 59-year-old female presents to the emergency department with a chief complaint of “head pain that comes and goes.” She describes the pain as a dull ache in her occiput that’s been striking without warning a couple of times per day […]

Spot the STEMI #1

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You have a 50/50 shot at getting this one right. Are you feeling smart… or lucky? Two 50-year-old men present complaining of chest pain x 1 hour. One patient is suffering from a very subtle acute STEMI while the other has a non-cardiac cause for his chest pain. Which patient is experiencing the subtle STEMI? […]

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