Archive for category: STEMI

R.E.B.E.L. ECG of the Week: Wellens’ Syndrome or STEMI

14 Aug
August 14, 2014

Wellens' Syndrome or STEMI

A 52 year old female with a past medical history of type II diabetes mellitus and tobacco abuse presents with a chief complaint of chest pain.

According to the patient she had about 2 – 3 months of stuttering, substernal chest pain without any radiation.  She described the pain as pressure-like, with activity, but that it would typically resolve after a few minutes of rest.  Today she awoke with substernal chest pain that never resolved and continued in the emergency department.  She quantifies her pain as 7/10 and not relieved with 2L nasal cannula of oxygen, 325mg PO aspirin, and SL NTG x3.

BP 127/89     HR 76     RR 20      O2 sat 100% on 2L NC     Temp 99.3

Awake, A&Ox3, appears uncomfortable
Mild JVD on examination
RRR w/o m/r/g
CTA B
2+ pulses in her extremities, no edema

ECG is shown (No prior ECG for comparison)…..

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R.E.B.E.L. ECG of the Week: LBBB and STEMI

09 Jun
June 9, 2014

R.E.B.E.L. ECG of the Week

89 year old male with PMH of hypertension, stage 3 chronic kidney disease with chief complaint of shortness of breath. Several days ago patient had a laminectomy for radicular pain. He was doing fine post-operatively and began to develop gradual shortness of breath.  He had no complaints of chest pain, nausea/vomiting, fevers, diaphoresis, but did have some weakness.  There were no prior ECGs for comparison.

BP: 98/48 HR: 103 RR: 18 O2 on RA: 94% Temp: 38.6

JVD to the angle of the mandible
Bibasilar Crackles
Sinus Tachycardia
Bilateral lower extremity pitting edema

Labs: Na 125, K+ 4.2, Creatinine 2, BNP > 2500

ECG from triage is shown… Read more →

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