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He reported a history of “Wolf-Parkinson-White” and “heartattack” but said neither had been treated. This has been discussed many times before on this blog. In-depth discussion is beyond the scope of this blog. Serial ECGs enhance the diagnosis of acute coronary syndrome. Washam, J. Peacock, W. Pollack, C.
He noted that his father died from a heartattack in his early 50s prompting his presentation to the emergency department. He reported substernal chest pressure with radiation to his left arm that started at work several hours prior to arrival and had somewhat improved since onset.
male presents because he "thought he might be having a heartattack." First, this patient had a known stent in the "marginal" artery and thought he was having a heartattack. Case 2 A 38 year old male with h/o smoking only c/o a few hours of severe substernal chest pain; he thinks he is having a heartattack.
Repeat CT angio chest (not CT coronary, unclear what protocol) showed possible LAD aneurysm and thrombus. Finally, coronary angiography was performed (at least 5 days after presentation) which confirmed LAD aneurysm with large thrombus burden, TIMI 0 flow, thrombectomy performed.
He stated it was similar to prior heartattacks. We've shown many cases on Dr. Smith's ECG Blog of subtle ECG findings that rapidly evolve into dramatic ST-T wave changes. Today's patient is high-risk ( ie, in a high "prevalence" group for having an acute coronary event ). The pain was still ongoing at arrival.
He reportedly told his family "I think I'm having a heartattack", then they immediately drove him to the ED, and he was able to ambulate into the triage area before he collapsed and became unresponsive. CPR was initiated immediately. (The
He reports this was similar to how he felt when he had his heartattack 4 years prior, now s/p 4 stents. PMCardio Queen of Hearts AI Model: The Queen of course also thinks it is acute OMI, for the same reasons. A 50 something male presented in the evening to ED for evaluation of chest pain that started at 1600.
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