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To PCI or not to PCI; please, review your guidelines
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59y/o male who arrived to the ED by EMS as a cardiac alert (STEMI). Pt started having substernal chest pain, sudden in onset while watching TV at home. Patient was given ASA 324 mg po and nitro 0.4 mg SL x2 prior to arrival. Upon arrival, patient looked acutely ill, diaphoretic, pale with active chest pain. The rest of the physical exam, unremarkable. BP 148/77mmHg HR 70/min RR 22/min O2 sat 97% 2L by nc. Known history of hypertension. Unknown medications. No other history available. Patient was too sick to give accurate history. 12 lead EKG provided by EMS. Cardiac cath team notified. However, the cardiac cath team initially refused to take the pt because there were no indications for immediate PCI. While scratching their heads while thinking whether to take the pt to the cath lab or not, I was giving them a 30 second lecture about EKG's. Then, the patient was taken to the cath lab.
Tags
aha acc guidelines, acute mi, curbside, pci, cardiac
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