An 82 year-old male with history of hypertension presents to the emergency department in the early morning for insomnia. He reports being awoken approximately 6 hours prior to arrival by a 2/10 "squeezing" pressure in his right chest that came on insidiously. The pressure has been constant since onset, is non-radiating, and associated with shortness of breath. The patient denies having any pain and describes his symptoms as rather a "gnawing discomfort." He reports feeling well the night before and denies having symptoms like this in the past. He denies any personal or family history of heart or lung disease. On review of systems he denies having nausea, vomiting, cough, fever, or chills.
Vital signs T 37.5 | P 102| 146/73 | 20 | 100% on RA
On exam the patient is an elderly male in minimal distress sitting upright in bed.
Heart sounds are rapid and regular with no murmurs or gallops.
Breath sounds are clear bilaterally.
An electrocardiogram is obtained and shown below:
How would you manage this patient?
The diagnosis for this case will be posted in approximately 1 week.
Vital signs T 37.5 | P 102| 146/73 | 20 | 100% on RA
On exam the patient is an elderly male in minimal distress sitting upright in bed.
Heart sounds are rapid and regular with no murmurs or gallops.
Breath sounds are clear bilaterally.
An electrocardiogram is obtained and shown below:
What is the diagnosis?
How would you manage this patient?
Please leave a comment below and share your thoughts.
The diagnosis for this case will be posted in approximately 1 week.
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