r/Paramedics • u/gurtstraffer • 3d ago

Cath Lab yes or no?

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5 Upvotes

74% Upvoted

13 comments sorted by

16

u/TovarichBravo 3d ago

Seems reasonable given the EKG and no pt history

7

u/SuperglotticMan 2d ago

If you go to the original post there’s a history. The first sentence is “old dude with chest pain, nausea, and history of MI” which is enough for me lol

1

u/Mediocre_Daikon6935 3d ago

Yep.

They might not do it if they have an old ekg to compare to, but if they don’t, I would be shocked if it didn’t go to the cathlab.

10

u/rads2riches 3d ago

15 because you think posterior with st depression in precordial leads.

3

u/dependentlividity 2d ago

STE in aVR & STD in 6+ leads = suggestive of either triple CAD or LMCA obstruction.

1

u/Anonymous_Chipmunk Critical Care Paramedic 2d ago

This is the answer.

1

u/Novel_Tension_3759 1d ago

Finally the correct answer

4

u/Salt_Percent 3d ago

I’m leaning towards a posterior, maybe some De Winters T waves…off to cath (/to the doctor who decides if they go to cath or not)

I’d be partial to running a 15-lead to see what we see there

3

u/andrewerideout 3d ago

Fuck a 15 lead, catch lab yes. Even without the depression, HATW everywhere

2

u/SuperglotticMan 2d ago

People are saying do a 15, but would a clean 15 be enough to convince you to think this is safe not to send to the cath lab? Just send it imo

1

u/Alarming_Seat_1791 2d ago

The global ischemia and aVR STE are screaming that the LMCA is probably almost completely occluded proximally... put the pads on, get the epi ready and cath this guy yesterday!

1

u/secret_tiger101 2d ago

Posterior MI.

1

u/BankrollTay 1d ago

Elevation in avR is always an ominous sign. Pt presentation/vital signs would likely corroborate.