This paper seeks to establish a provisional diagnosis from presenting signs and symptoms and discuss the supporting pathophysiological implications of the prognosis, based on the following case study. Bill is a 62-year-old male who self-presented with a cardiovascular emergency at a small regional health centre. The information gathered in the primary and secondary surveys allows the formation of an evidence-based prehospital management plan including optimal pharmacological therapy and other interventions as well as additional resources required, destination hospital choice and consideration of further diagnostic tests. In Bill’s scenario he presented with discomfort in his chest and jaw. He stated that his pain began an hour ago as 7/10
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In reviewing his family history, we discover diagnosis of heart disease and acute myocardial infarction on both sides of the family. This indicates that he has a genetic predisposition to these conditions (Chandrasekhar, Cholamugath, Baby, & Pattani, 2015). It was also observed that Bill had an elevated respiration rate of 20 breaths per minute and mild shortness of breath on slight exertion. His skin was seen to be cool, pale, mildly diaphoretic and he reported feeling anxious and intermittently nauseous. He was found to have a systolic blood pressure of 110mmHg and all other measures were within normal parameters with no adventitious sounds bilaterally on auscultation. These observations may lead one to suspect Bill to be experiencing myocardial infarction (Phalen & Aehlert, 2012). Interpretation of a 12-lead ECG is crucial in differentiating the diagnosis (Reeder & Kennedy, 2017). Upon initial observation of Bill’s ECG trace it is apparent that he may be experiencing an ST elevated myocardial infarction (STEMI) due to the presence of ST-segment elevation in a number of
In reviewing his family history, we discover diagnosis of heart disease and acute myocardial infarction on both sides of the family. This indicates that he has a genetic predisposition to these conditions (Chandrasekhar, Cholamugath, Baby, & Pattani, 2015). It was also observed that Bill had an elevated respiration rate of 20 breaths per minute and mild shortness of breath on slight exertion. His skin was seen to be cool, pale, mildly diaphoretic and he reported feeling anxious and intermittently nauseous. He was found to have a systolic blood pressure of 110mmHg and all other measures were within normal parameters with no adventitious sounds bilaterally on auscultation. These observations may lead one to suspect Bill to be experiencing myocardial infarction (Phalen & Aehlert, 2012). Interpretation of a 12-lead ECG is crucial in differentiating the diagnosis (Reeder & Kennedy, 2017). Upon initial observation of Bill’s ECG trace it is apparent that he may be experiencing an ST elevated myocardial infarction (STEMI) due to the presence of ST-segment elevation in a number of