Is this patient having an Acute Myocardial Infarction at this present time or did he have the infarct 2 weeks ago when the patient first had central chest pain?
This is an interesting case... The story here is:... an good friend and colleague of my recently got a call for a immediate transfer from one hospital to another to take a patient for PCI... My colleague was stuck in the middle of 3 consultant cardiologist's aurguing whether the patient was having an AMI at the present time or is the ECG changes from 2 weeks ago when the patient actually had the first chest pain.
Outcome was 2 cardiologists decided that the patient was having an AMI now, and the 3rd cardiologist thoughts were these events are from when the patient first infarcted 2 weeks ago. In the end the outcome was they decided NOT to PCI this patient.
Sorry I have not much clinical information on this patient whether he has any cardiac history, I understand the patient's english was very poor... Observation's were recorded as follows:
SPO2: 99% O2
SKIN: No details: just my colleague stated that this patient did not present like he was having a AMI.
No other info on this patient regarding blood results...etc.
My Questions are:
1) What your opinion on this case study?
2) After looking at these ECG's, do you think present events or is the infarct 2 weeks old?
3) Would you PCI ?
4) Give evidence and your reasons from the features on the 12 lead ECG, whether this is 2 weeks old or AMI?
Lead II taken from the rhythm strip
Hospital captured 12 Lead ECG
This is a interesting case to hear from cardiologists with their opinions on this case study, or any other health care professional's sharing their views... Look forward to all your comments...:-)