Conclusion: 53 YOF with AMS: STEMI or Secondary ST-T changes?

This is the conclusion to the previous case: 53 YOF with AMS: STEMI or Secondary ST-T changes? This female presented to the ED with Altered Mental Status (AMS), via ambulance, as STEMI ALERT, after completing approximately 3 hours of her usual dialysis. This was the 12 lead ECG provided by EMS…   We have a sinus rhythm with Bi-atrial Enlargement or Abnormality and Left Ventricular Hypertrophy with Secondary ST-T changes. We can categorize ST-T changes as Primary or Secondary. Primary ST-T changes refer to changes due ischemia Secondary ST-T changes refer to non-ischemic repolarization abnormalities (i.e. LVH, Bundle Branch Blocks, ect…) What does this mean? This is not a STEMI, but rather ST segment elevation due to altered ventricular repolarization. A prior ECG from a previous visit was significantly similar, but we were unable to obtain a hard copy. So remember the main reason the dialysis center called EMS? AMS. The patient was found to be hypoglycemic and was treated with 25 g of Dextrose 50% with improved mental status and GCS. The following 12 lead ECG was obtained:   Both computerized ECG interpretation recognized Secondary ST-T changes, as well as Atrial abnormality, with no STEMI recognized. Although the computerized interpretation is accurate in most case, our ability to interpret ECGs is one of the most important skills as healthcare providers and clinicians, which is why we will break down our findings in this case. What do we see? Sinu...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: Uncategorized Source Type: research