A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
Figure 1. Index ECG notable for repolarization abnormalities of leads III and V2.
A 50-year-old male with a history of tobacco use disorder presents with 1 week of intermittent, central, pressure-like chest pain that lasts a few minutes at a time without clear exacerbating or relieving factors. He had a particularly severe episode just before arrival but is now pain free. The initial ECG is shown in Figure 1.
Samson Frendo, MD and Adam Roussas, MD
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The Case:
A 72yo M presents via EMS for chest pain that started while chopping wood. Initially, an ECG was sent by EMS en route with concern for ST-segment elevation. 324 mg PO aspirin and 400 mcg of sublingual nitroglycerin were administered prior to arrival. Vitals per EMS were notable for bradycardia and hypotension.
Stewart Pine, MD
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Figure 1. Index ECG notable for sinus tachycardia with S1 Q3 T3 pattern.
The Case:
A 58-year-old M with no reported PMHx presenting with shortness of breath and the following ECG. The patient endorses 1 week of exertional dyspnea that evolved to include pleuritic chest pain one hour prior to arrival. He had severe shortness of breath on awaking. He denied hemoptysis, lower extremity edema, calf pain, history of VTE, hormone use, recent surgery, or prolonged immobility.
Jose Reyes, MD
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