Wednesday, 8 December 2010

43 year old female CC: Chest pain

EMS is called to the residence of a 43 year old female with a chief complaint of chest pain.

On arrival, the patient is found supine in bed.

She is alert and oriented to person, place, and time.

She is anxious and diaphoretic.

Past medical history: Hypertension
Surgical history: One kidney removed (unknown reason)
Medications: Azor

She denies shortness of breath and breath sounds are clear bilaterally.

Onset: 1 hour prior to EMS arrival
Provoke: Nothing makes the pain better or worse
Quality: Severe "pressure"
Radiate: The pain radiates down the left arm
Severity: 10/10
Time: No previous episodes of similar pain or pressure

Vital signs:

RR: 18
Pulse: 76
NIBP: 114/71
SpO2: 98 on RA

The cardiac monitor is attached.

A 12-lead ECG is captured.

How would you treat this patient and why?