And, I mean really basics. We don’t spend much time talking about EKG reading in my Pathophysiology class because my own background is limited. However, I have asked that students be able to identify a normal EKG vs a ST elevated EKG; which signifies, along with other signs, such as cardiac enzymes in the blood; that a patient has had a heart attack.
(by the way, I would like to say right up front, that I happily accept comments that can improve this post)
Case Report:
A patient (65 yo male Caucasian) arrives in the ER after having severe chest pain radiating into the left arm, neck and jaw. The patient has a history of hypertension, some atherosclerosis, and spasms of the coronary arteries. Patient smokes 1/2 pack per day, and drinks approximately 1-2 beers a day. When symptoms set in, he took a Nitroglycerine tab under his tongue, but experienced no relief. His wife drove him in to the ER as he was experiencing nausea.
A blood test for cardiac proteins indicated that Troponins (Tn T and Tn I) were both present in serum at 10x the upper reference limits. His EKG appear as:
Click image for live EKG
What is your diagnosis?
What do the elevated Troponins indicate?
Suzie
May 19, 2021 at 11:57 pm
ST elevation (ventricular interval between depolarization and repolarization) is a strong indicator of an MI with elevated Troponin meaning enzymes are released after muscle injury or death, indicative of an MI, esp. with risk factors presented. Treat patient with sublingual nitro, morphine rush to catch lab and possible CABG.