Saturday, June 24, 2017

A 50-year-old man is seen in the Emergency department with severe central chest pain...

A 50-year-old man is seen in the Emergency department with severe central chest pain which he says is present for about 18 hours.
His ECG is shown below:

Question:
What does this ECG show and how would you manage this patient?

Answer:

The ECG shows:
• Sinus rhythm
• Normal axis
• Q waves in leads V2-V4
• Raised ST segments in leads V2-V4
• Inverted T waves in leads I, VL, V2-V6

Clinical interpretation
This is a classic acute anterior myocardial infarction.

Diagnosis: Acute anterior myocardial infarction

How To Manage: 
More than 18 h have elapsed since the onset of pain, so this patient is outside the conventional limit for thrombolysis. Nevertheless, if he is still in pain and still looks unwell, thrombolytic treatment
should be given unless there are good reasons not to do so. In any case he should be given pain relief
and aspirin, and must be admitted to hospital for observation.

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