Saturday, 13 March 2010

56 year old male c/o Chest Pain

56 year old male presents with acute onset of sudden central chest pain radiating down both arms with pins & needles sensation, patient found sitting in chair.

This p/t has had 4 previous MI's with stents fitted, p/t stated that pain feels different from previous MI's. Patient stated he had the feeling of impending doom.

Skin: dry, look well perfused (pink)... but had been on oxygen for some time given by the responder, before the arrival of the crew...

Pain score 08/10

No nausea or vomiting

Past medical history:

Previous MI's

Vital signs:

BP: of 123/49 (Low for this p/t)
HR: 72
RR: 22
SpO2: 99%, 100 on O2 via NRB mask @ 15 LPM
BM: (blood sugar) 5.4 mmol/l
Temp: 36.7

Lead III strip above and Pre-hospital 12-lead ECG

Ventricular rate: 80
PR interval: 120 ms
QRS Duration: 166 ms
QT/QTc: 418/482 ms
P-R-T axes  13 72 -3

Emergency Department 12-Lead ECG

Please comment on the features of this ECG:

What findings do you see ?

For experienced members in cardiology, please use this ECG as a teaching tool, passing on your knowledge and experience to others.