Tag Archives: STEMI

"What Happened?"–Discussion

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This is the discussion to "What Happened?" You may wish to review the case here. Ok, let's review the initial 12 Lead: Just about everyone picked up on the infero-posterior STEMI. Where it got interesting for me, was determining what the rhythm was! At first glance, the rhythm was for the most part regular (note […]

Elderly Female: Chest Pain-Discussion

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This is the discussion for Elderly Female: Chest Pain. You may wish to review the case. Ok, this was not an obvious case, at least, not until the end.  As far as the patient goes, I think we all agree about the differentials: ACS vs. possible aortic dissection (due to the pain radiating to her […]

Conclusion to "41 Year old female: chest pain"

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This is the conclusion to 41 year old female: chest pain. I think we would all agree the patient presentation is suspicious for ACS. Let's review the first 12 Lead: The rhythm is sinus tach. There is about 1mm of ST elevation in V1, and depending on where you spot your J point, little to […]

41 Year Old Female: Chest Pain

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Here's an interesting case sent in by faithful reader Carl R. Christiansen, Paramedic, from Norway. As usual, changes have been made to protect patient confidentiality. It's an early Sunday morning when you are dispatched to a hotel for a 41 year old female with chest pain.  You and your partner enter the hotel room and […]

Discussion to 63 year old male: chest pain – Wellens' Syndrome? Or something else…

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This is the discussion for 63 year old male: Chest Pain. Many of you thought the original 12 leads showed Wellens' Syndrome.  Lets review some key points about the T wave inversions of Wellens' for a moment: They occur when an occluded artery is reperfused, spontaneously or otherwise They are always recorded during a pain […]

54 year old female CC: BLS intercept – Conclusion

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This is the conclusion to 54 year old female CC: BLS intercept. I did not expect to get so many comments! Great discussion on many points. It even afforded an opportunity to review atrioventricular blocks. Going back to the case let’s look at the initial 12-Lead ECG. As many readers noted, there is a lot […]

Regionalization in EMS (End-of-year column at EMS1.com)

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My “End-of-Year” column is up at EMS1.com. Trends in 2010: Regionalization in EMS Enjoy!

69 year old male CC: Chest pain

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Christopher A. Watford from the My Variables Only Have 6 Letters blog has submitting a very interesting case study (actually he submitted two but you’ll have to wait for the other one). EMS is called to the residence of a 69 year old male complaining of chest pain. On arrival the patient is found sitting […]

47 year old female CC: Chest pain – Discussion

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Thanks for all the comments! I’m not allowed to blog while I’m on duty (the policy has nothing to do with me personally) so if it seems like I’m not responding, I’m probably just at work. The paramedic who submitted this case has requested the follow-up information from his supervisor, but unfortunately she’s out-of-town for […]

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!”

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