Tag Archives: serial ECGs

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 […]

66 year old male with chest pain and acute STEMI identified with serial ECGs

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Here’s a great case submitted by Nick Ciaravella of Grady EMS in Atlanta, GA. 66 year old male presents to EMS with chest pain. SAMPLE history S – Chest Pain A – None M – Atenolol, HCTZ P – Hypertension L – meal, 7 hours prior to event E – Mowing his lawn OPQRST O – Started […]

26 year old male with chest pain and acute isolated posterior STEMI

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Here’s an interesting case submitted by a faithful reader who wishes to remain anonymous. EMS is called to a 26 year old male complaining of chest pain. On arrival patient is found sitting on his living room couch. He appears anxious and acutely ill. The location of the chest discomfort is in the center of […]

57 year old male CC: Chest pain

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Here’s a very interesting case submitted by FF/medic Tim Porter (c/o a faithful reader). The patient is a 56 year old male with a chief complaint of chest pain. Onset: Approximately 30 minutes prior to EMS arrival Provoke: Nothing makes the pain better or worse Quality: Described as intense pressure Radiate: The pain does not […]

43 year old female CC: "Indigestion-like" chest discomfort

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Thanks to Jim Tarro for the following case study 43 year old female presents to EMS with “indigestion-like” chest discomfort. She states that it “feels like a previous heart attack.” Onset: Several hours ago Provoke: Antacids make the pain feel better Quality: “Indigestion-like” chest pain Radiate: The pain does not radiate Severity: She gives the […]

Found on the Lifenet Receiving Station

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Here’s an interesting set of ECGs I found on the Lifenet Receiving Station. They were transmitted to the emergency department by a neighboring EMS system. I have no details of the history or clinical presentation. ECG #1 ECG #2 What do you think?

The Only Constant Is Change

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In this excellent article from the March 2007 Journal of the Emergency Medical Services, Tim Phalen discusses the importance of performing serial 12 lead ECGs. Here are some of the highlights. “Acute myocardial infarctions (AMIs) aren’t like broken bones and, therefore, ECGs aren’t static like X-rays. If an EMS crew were treating a hip fracture […]

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