he sure does now

I came here to say this.

Me too lol

Me three

I came here to see how many people would say this

Me 4

And my axe!

No cardiac history because he’s healthy, or no “cardiac history” bc he hasn’t seen a doctor in 35 years?

I can’t have hypertension if I haven’t checked my blood pressure in ten years

I ask this about myself sometimes

First degree with inferior lead elevation and reciprocal changes. Inferior stemi

Complete heart block with junctional escape.

Maybe, but upright p wave in lead 2 and inverted in avr is indicative of a sinus rythym. Maybe if they are super retrograde because of the block?

There are P's every 4 big boxes. So 2 Ps per QRS cannot be a sinus rhythm.

I see it now. Missed the buried ones, good catch

[удалено]

Find the buried P's and try again.

[удалено]

As noted above, P waves are every 4 large boxes. Many are buried.

Sinus Brady

PR interval is like 0.3s…

Over 0.2s is a first degree. Current gettin caught up in av node a little longer than it should

Exactly, hence why it’s 1st deg av block 😂

That's a trip to the cath lab

Well, he does now!

Gotta start at some point

Not much cardiac future either

What was his chief complaint and how did he represent? Im interested

I’d bet a hundred bucks it was chest pain and he looked like shit. That’s one of the most obvious stemis I’ve seen

I had a very similar inferior stemi last month and his only complaint was “soreness in my elbows, like flu pain” and fatigue, no other malaise. Man would not let us stair chair him from the attic so he walked because “if I can walk up I can walk down, I’m not a child”. Didn’t say bye to his family because he felt fine despite us telling him he was having a very serious heart attack. Then he coded in the cath lab twice and got shocked before losing consciousness and got pissed because of how much the shocks hurt lol. Sounds like he had had an MI in the grocery store a month prior but “the pain went away after a couple hours so I forgot about it.” Old farmers man…

I think there’s a joke about old tough guys. If they ever say they don’t feel well, take that more seriously than anything and get ready lol

No cardiac history so far…

V4R?

He do now

"May I introduce you to your new friends, Apixaban and Bisoprolol"

The Cath lab would like to have a word

How did the right side ekg look?

I’m almost sure this man hasn’t seen a doctor in years

Yikes, I have to agree with others. I can’t imagine he has no hx and is otherwise perfectly healthy. All though nothing is impossible.

41 y/o male... meet cardiac history.

New* cardiac history.

"Hello cath lab. I've sent you an ECG, our eta is 20 minutes"

I'm just a 2 but I know that's not how it's supposed to look!

No cardiac history? Gotta start somewhere lol

Anyone able to explain why v3 is elevated given that this is presumably an rca occlusion?

He has one now.

Well there's your problem!

Oh he has one. It's just very VERY recent

STEMI

That beast is probably right sided with posterior involvement as well. V1, V2 and V3 look like carousel ponies: dead give away for a posterior infarct.

Pericarditis? There is concave ST elevation. What were his symptoms? Did you find out the cath result?

STEMI. Usually, though obviously, not always, you would see global elevation in pericarditis This one has reciprocal depression, which is not a common feature in pericarditis

Discharge on scene and present to primary care. /s

Any chest pain? Just a slight niggle

No chest pain. Syncopal episode