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Male patient with chest pain and wide complex rhythm

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EMS is called to the residence of a 78 year old male. It’s the middle of the night. The patient’s spouse meets you at the front door and brings you back to the bedroom. The patient is sitting on the edge of his bed. He is highly anxious and complaining of chest discomfort and palpitations. […]

76 year old female CC: Chest pain – Conclusion (Takotsubo Cardiomyopathy)

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Here is the conclusion to the most recent case: 76 year old female CC: Chest pain. To see Part I click HERE. To see Part II click HERE. The patient was transported to the emergency department where she was treated for a possible acute coronary syndrome. Serial 12-lead ECGs and cardiac biomarkers were performed. This […]

76 year old female CC: Chest pain – The case for this being an acute anterior STEMI

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As many of you pointed out, the history and clinical presentation isn’t exactly screaming “Acute Coronary Syndrome!”

Return of the Geordie

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Just in case you didn’t know, Mark Glencorse (999Medic.com) is back from his hiatus from blogging. Also, congratulations to Mark on his new column in the Journal of Paramedic Practice (JPP) called Blog Watch! The August 2010 edition is out and Mark was kind enough to include the Prehospital 12-lead ECG blog. Mark mentions the […]

76 year old female CC: Chest pain

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EMS is called to the beach for a 76 year old female complaining of shortness of breath. Past medical history of emphysema. On arrival, the patient is found sitting in a beach chair alert and oriented to person, place, time, and event. She does not appear to be in any acute distress. The patient states […]

53 year old female CC: Chest discomfort and shortness of breath

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Here’s an awesome case submitted by Nathan Stanaway of Grady EMS in Atlanta, GA. The patient is a 53 year old female c/o chest discomfort and mild dyspnea. The pain is described as “severe” and she gives the pain a 10/10. Past medical history is significant for migraine headaches and anxiety. Patient is a poor […]

37 year old male CC: "Light-headedness" – DISCUSSION

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This is the discussion for the case study: 37 year old male CC: “Light-headedness” (posted earlier this week). Here’s the question asked by the paramedic who submitted the case. “The first 12 lead ECG shows Q-waves in the inferior leads. Perhaps this isn’t a surprise considering the patient’s history of MI. But what about the flipped […]

37 year old male CC: "Light-headedness"

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I received an excellent question this week from a reader who chooses to remain anonymous. Before we get to his question (and my answer) let’s take a look at the case that prompted the question. EMS is called to the residence of a 37 year old male c/o “light-headedness”. Upon EMS arrival the patient is […]

79 year old female CC: Unresponsive

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Here's a very interesting and unusual case submitted by a long-time reader of the Prehospital 12-Lead ECG blog named Christopher Linke (aka SoCalMedic). I'll warn you up front that the patient insisted on being transported to a hospital without specialty services so we have no information about diagnostic testing that might confirm the diagnosis. EMS […]

58 year old male CC: Chest discomfort

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Here’s another case from a faithful reader who wishes to remain anonymous. No, these are not all from the same anonymous reader! EMS responds to a 58 year old male complaining of chest discomfort. Onset: 30 min ago while mopping hot tar on roof Provoke: Nothing makes the pain better or worse Quality: Dull pressure […]

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