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A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon. Diagnosis of Type I vs. Type II Myocardial Infarction in EmergencyDepartment patients with Ischemic Symptoms (abstract 102).
IF YOU OR A LOVED ONE NEEDS HELP, CALL 988 OR SEEK CARE AT A LOCAL EMERGENCYDEPARTMENT. CAD notes indicate that the caller was walking in the park and came across a vehicle in the far corner of the parking lot. REMEMBER, IF YOU ARE TREATING A SUICIDE ATTEMPT SURVIVOR, DO NOT PASS JUDGMENT.
Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. His father had a minor heart attack at the age of 63. AEM June 2022.
Otherwise, no admission of CAD, HLD, or family history of sudden cardiac death. A 12 Lead ECG was recorded: This is pathognomonic for classic deWinter T waves, indicative of LAD occlusion.
Upon arrival to the emergencydepartment, a senior emergency physician looked at the ECG and said "Nothing too exciting." Just because you don't see hemodynamically significant CAD on angiogram does not mean it is not OMI. I could have told you this (and did tell you this) without an MRI.
Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergencydepartment with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. 1] European guidelines add "regardless of biomarkers".
She was unable to be defibrillated but was cannulated and placed on ECMO in our EmergencyDepartment (ECLS - extracorporeal life support). Diagnosis of MINOCA should be made according to the Fourth Universal Definition of MI, in the absence of obstructive coronary artery disease (CAD) (no lesion ≥50%). myocarditis).
A 59-year-old male with a past medical history of a repaired ventricular septal defect (VSD), dextrocardia, hypertension, hyperlipidemia, and current smoker presented to the emergencydepartment (ED).
So I went to look at the chart and here is the history: This patient with no h/o CAD had a couple of episodes of chest pain during the day, then presented with one hour of substernal chest pain that had some reproducibility but also improved from 10/10 to 5/10 with nitroglycerine. Ann Emerg Med 1998;31(1):3-11.
I finished my residency of Emergency Medicine and I’m working at a great EmergencyDepartment here in Brazil. Angiogram soon after (around 4 hrs after presentation) showed multi vessel CAD, with culprit lesion total occlusion of the first obtuse marginal branch (OM1), which was stented. No more troponins were obtained.
At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the EmergencyDepartment Case 1. This was a 100% acute LM occlusion.
Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve Smith Case A 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain similar to his prior MI, but worse. The pain initially started the day prior to presentation. The ST elevation from today is ~0.2
IIa C Pre-hospital logistics Management Recommendation Level of evidence The pre-hospital care of STEMI patients should be organized regionally (including all components from the emergency medical dispatch to catheterization laboratory) in order to provide reperfusion therapy as early as possible.
Written by Pendell Meyers A man in his late 30s with history of hypertension, tobacco use, and obesity presented to the EmergencyDepartment for acute chest pain which started approximately 3 hours prior to arrival, in the setting of a very stressful situation. Scattered other nonobstructive CAD.
Written by Jesse McLaren, with comments from Smith An 85 year old with a history of CAD presented with 3 hours of chest pain that feels like heartburn but that radiates to the left arm. Below is the ECG. What do you think? There’s sinus bradycardia, first degree AV block, normal axis, delayed R wave progression, and normal voltages.
These are very commonly encountered in the emergencydepartment, so being able to correctly identify the rhythm is extremely important. He has a history of CHF, dilated cardiomyopathy, HTN, HLD and CAD. This week, we are finishing 4 of a 4-part series tackling tachydysrhythmias. Lets dive in! Take a look: Figure 3.
She presented to the EmergencyDepartment at around 3.5 The procedure was described as very complex due to severe multivessel CAD, but ultimately PCI was successfully performed to the ostial LCX. The chest pain was described as severe pressure radiating to both shoulders. Vital signs were within normal limits. hours since onset.
Case A 68 year old man with a medical history of hypertension, hyperlipidemia, and CAD with stent deployment in the RCA presented to the emergencydepartment with chest pain. Also : See Ken Grauer's excellent comments at the bottom. He developed it only 20 minutes prior to presentation while cutting branches outside.
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