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You may return the EKG answers to the EKG box or e-mail them to Dr. Rao at parinamrao@gmail.com by 2/28/07.
Name:
A 64 year old male presents to the emergency department complaining of crushing pressure like chest pain, radiating to his left arm and neck which started 3 hours prior. The pain is worse than his typical angina and is not relieved by nitroglycerin. You contact his PMD, who informs you that he had a stent placed last year, as well as a PMH of DM, HTN, diabetic retinopathy, and a small cerebral infarct 9 months ago. He also reports that the patients’ EKG last week was normal which you confirm by fax. Cardiology and cardiac catheterization are not available. CXR and physical exam are normal.
What does the EKG show and what is the diagnosis?
Rate:
Rhythm:
Axis:
PR:
QRS:
ST:
EKG diagnosis:
Clinical diagnosis:
Treatment:
What are the indications for thrombolysis (specifically time to treatment, ST elevation height and EKG changes)?
What are the five “absolute contraindications” to thrombolysis (as per Tintinalli)?
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