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David Didlake EMT-P, RN, ACNP @DidlakeDW An adult male self-presented to the ED with palpitations and the following ECG. Ultimately the patient went to Cath and was found to have multi-vessel obstructive coronary disease with an acute LCX culprit vessel, which was stented.
David Didlake, FF/EMT-P, AG-ACNP @DidlakeDW An elder female presented to the ED with worsening shortness of breath. She was known to have a history of poorly controlled COPD, AFib, and multivessel coronary disease.
As an Emergency Medical Technician (EMT), your knowledge of this intricate system, the conditions that can arise, and the interventions necessary to save lives is fundamental to your role. Let’s dive in and unravel the complexities of the cardiovascular system and the crucial role you play as an EMT in managing heart conditions.
The fire department, who operate at an EMT level in this municipality, arrived before us and administered 324 mg of baby aspirin to the patient due to concern for ACS. Such cases are classified as MINOCA (Myocardial Infarction with Non-Obstructed Coronary Arteries). An angiogram is a "lumenogram;" most plaque is EXTRALUMINAL!!
But STEMI criteria has poor sensitivity for acute coronary occlusion. Like the initial hemoglobin level in acute hemorrhage, the initial troponin in acute coronary occlusion can be falsely reassuring. In the STEMI paradigm, patients with ischemic symptoms and ECGs that don’t meet STEMI criteria get serial ECGs.
Sincerely, Alex Gregory, MD Editor-in-Chief AAEM/RSA Modern Resident Blog Top 10 Most Read Posts of 2020 Should ST elevation in lead aVR with concern for acute coronary syndrome prompt emergent coronary angiography?
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