Question

D.R. is a 55 year-old man who was admitted from the Emergency Department with the acute onset of mid-sternal chest pain, radiating down the left arm and up the left side of the neck. The patient’s pain level is 7/10, he complains of shortness of breath and is cool, pale, and diaphoretic. Blood pressure is 160/90, pulse 110, respiratory rate 28. Cardiovascular risk factors include: history of hypertension (controlled), positive family history (dad died at 46 with sudden cardiac death), he smokes ½ pack per day for about 30 years. He is terrified that he is going to die and grabs your arm every time you enter the room to talk with him or provide care. The initial 12-lead ECG reveals sinus bradycardia with a P-R interval of .24 seconds, anterior ST segment elevation with T-wave inversion. Additionally, several leads show significant Q waves.

What does this information tell you?

What action is indicated?

Answer 1

Information:

Patient is having myocardial infarction.

Rational:

Patient complaints are significant to M.I,

Sternal chest pain radiates to left arm, left neck.

Dyspnea, pallor, diaporosis.

Patient history also significant

ECG also reveals M.I

ST elevation, prolong PR interview, significant Q wave.

2. Action indicated:

M= Morphine

O= oxygen therapy

N= Nitroglycerin

A= Aspirin

Other supportive therapy: