Case Study 2, part I:
A 54 years old male was transferred for further evaluation of chest pain. During a couple of weeks he had been experiencing chest pain on exertion with increasing frequency. He was on treatment with warfarin and dual antiplatelet therapy due to atrial fibrillation and suspected unstable angina. On admission the patient appeared at ease and did not complain of chest pain, chest discomfort or dyspnea. Blood pressure was 135/87 mmHg, pulse was irregular at 95 bpm. A routine EKG was performed and is shown above.
How would you interpret this EKG?
What are the differentials?
What is the next step?
See the next EKG in this case in part II
Related content
Sound of silence – part I
Sound of silence – part II
Sound of silence – part III
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Atrial fibrillation with an inferior wall myocardial infarction. Given the frank elevation and reciprocal changes I can’t really think of any other differentials!
Next step is ASA, early STEMI notification, IV’s, a look at V4R, NTG titrated to pain level, fentanyl as an adjunct if required. Explain the PCI procedure to the patient during a safe and expeditious trip to the cath lab.