Occlusion myocardial infarction is a clinical diagnosis

Occlusion myocardial infarction is a clinical diagnosisWritten by Willy Frick (@Willyhfrick).  Willy is a cardiology fellow with a keen interest in the ECG in OMI.A woman in her late 70s presented with left arm pain. The arm pain started the day prior when she was at the dentist ' s office for a root canal. Her systolic blood pressure at the dentist was over 200 mm Hg. She was given nitroglycerin which improved her blood pressure, and she completed the procedure. Her arm pain abated. The pain returned that evening and woke her from sleep. She eventually fell back asleep, and woke up feeling normal the next day (the day of presentation). After dinner the day of presentation, she had left neck and elbow pain which she described as dull, achy, and worse with exertion. She contacted her neighbor, a nurse, for help. The neighbor recorded a systolic blood pressure again above 200 mm Hg and advised her to come to the ED to address her symptoms.The patient presented to triage at around 10 PM. Triage documented a complaint of left shoulder pain. The patient said, " I just don ' t feel good. " If an immediate EKG was obtained, it was not saved in the medical record. The patient had a first hsTnI drawn at 10:30 PM, which resulted at 202 ng/L (ref.<14). The first available EKG was recorded just after midnight, presumably around the time the result of the troponin came to clinical attention. It is not known what symptoms she was experiencing at this time, but it is reasonable to a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs