Myocardial Infarction, ST Elevation/Case Studies
Case 1
A 65-year-old female with a history of hypertension and DM type 2 was admitted to the general medical floor with fever and cough for 3 days.
The patient was diagnosed with community-acquired pneumonia and was started on levofloxacin. She improved and her fever resolved.
On hospital day 3, the patient complained of severe pressure-like substernal chest pain with radiation to the left shoulder of 20 minutes duration. The pain was associated with sweating and nausea.
The on-call internal medicine resident was paged. The patient was sitting on the edge of the bed and looked very distressed.
Her vital signs showed temperature of 36.5°C, heart rate of 88 bpm, blood pressure of 160/95, respiratory rate of 24/min, and blood oxygen saturation of 98% on room air.
The patient has a history of poorly controlled diabetes mellitus type 2, hypertension, and hypercholesterolemia. She is a heavy ex-smoker. Physical examination is significant only for crackles over the right lower lung base.
ECG
