ACS in 12 minutes!

by Khalid Mohammed Ali, Shirley Ooi from Singapore.

A 46 years old man with a past medical history of hypertension and hyperlipidemia developed central crushing chest pain associated with sweating and shortness of breath while driving. He presented to the emergency department 1 hour after the onset of chest pain. On physical examination, his vital signs were as follows; pulse rate: 60 beats per minute, blood pressure: 100 over 50 mmHg, respiratory rate: 20 per minute, Oxygen Saturation: 98% on room air. Patient has no leg edema, new murmur or features of heart failure. ECG is given on the side.


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ECG features are ST elevation in inferior leads with reciprocal changes in lateral leads of I, aVL and ST depression in lead V1, V2. The ECG is diagnostic of inferior and posterior wall ST elevation MI.

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