Tag Archives: ECG

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 […]

54 year old male CC: Chest pain – Discussion

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This is the discussion for 54 year old male CC: Chest pain. Once again we see the importance of serial ECGs in the treatment of a suspected ACS patient. The difference between the first and second 12-lead ECG is the key to solving this case. As you can see, the T-waves become more pronounced in leads […]

54 year old male CC: Chest pain

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Here’s an interesting case submitted by Terry Weatherford, NREMT-P. EMS responds to a report of a 54 year old male complaining of chest discomfort. O—Sudden onset P—Nothing made the pain better or worse Q—Stabbing R—Radiated to left shoulder S—9/10 T—Less than 30 minutes Vital signs: B/P 110/78 HR—70 Resp—20/min. Pulse ox 100% with O2. S—Nausea […]

69 year old male CC: "Indigestion"

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Here’s a case from a faithful reader who wishes to remain anonymous. In his own words: Presenting Complaint – Chest Pain History of Present Complaint – 69 year old male, nil cardiac history, none smoker, social drinker. Complaining of indigestion last 2-3 weeks with noticably increase in belching. This a.m acute onset of burning heavy […]

79 year old male CC: Shortness of breath

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Here’s another interesting case submitted by Geoff Dayne. 79 y/o male c/o non-provoked SOB without CP. Patient was found sitting upright, tripodding, 1 word dyspnea. Lung sounds: extremely decreased tidal volume. EMS crew was unable to tell if there was rales or wheezing. Past medical history: HTN, dyslipidemia, CHF, pacemaker (recently implanted within a week […]

The missed STEMI

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Here is the history of present illness recorded by the physician at the time of the patient’s arrival in the emergency department. “This 67-year-old male presents via EMS for evaluation of weakness, dehydration and one episode of nausea/vomiting. The symptoms began after approximately one hour of jogging this morning. The patient did not eat breakfast […]

Rhythm Challenge #4 – Discussion

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I’d like to thank everyone for the great comments on the most recent “rhythm challenge”. This turned out to be a more interesting rhythm strip that I thought! I’m going to break this down using some standardized steps that I follow for difficult rhythm strips. When I look at a strip, the first thing I ask […]

74 year old male CC: Chest pain

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74 year old male presents to EMS with a chief complaint of chest pain. Onset approximately 1 hour prior to the 9-1-1 call. No further details of the OPQRST are currently available. I will update the case with this information as soon as it is available, along with the physical exam. Vital signs: Resp: 20 […]

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