Paramedics make a great call
A middle-aged male called 911 for chest pain. Here was the first prehospital ECG with pain at 5/10: Computerized QTc is 418 ms. There is…
First ED ECG is Wellens’ (pain free). What do you think the prehospital ECG showed (with pain)?
This male in his 40’s had been having intermittent chest pain for one week. He awoke from sleep with crushing central chest pain…
Subtle Anterior Transient Injury Pattern, Not Appreciated, LAD occlusion spontaneously reperfused
This 41 yo male was cleaning using a chemical and experienced sudden substernal chest burning radiating to both arms with SOB, relieved by…
Wait until after the ECG to give Nitroglycerine
Here is the ED ECG of a 58 yo male whose chest pain is resolved: There is sinus rhythm with a PAC (which has aberrant conduction…
Missed STEMI, spontaneously reperfused
Click here for other very instructive cases of missed STEMI. This is a 48 yo female with no risk factors for CAD had sudden onset of arm…
Would you activate the cath lab prehospital?
A 54 yo with history of hypertension awoke in the AM with substernal chest pain. It did not abate, so at 0930, he called 911.…
Prehospital ST Elevation and pain resolve with NTG. ECG and Echo normal in ED.
The resolution of symptoms and the ECG in this case is similar to the last post, but the ST and T-wave morphology of the ECGs are quite…
Take a look at this prehospital ECG:
Follow on Twitter: smithECGBlog A 49 year old woman with chest pain arrived. The medics had recorded this ECG. What is the…
Chest pain, resolved: don’t forget to look at the previous and the prehospital ECG
This is a 58 year old woman with a history of inferior MI. She has had a week of intermittent substernal chest heaviness associated with…
Right Bundle Branch Block with Acute ST Elevation Seen Best on Prehospital ECG
This patient is 38 years old with hyperlipidemia. He was at the gym when he had the onset of chest pain. EMS was activated and recorded the…