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Treating her well.

Joris M G Theunissen1, Heleen Lameijer2

  • 1Department of Emergency Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands.

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Summary
This summary is machine-generated.

A 44-year-old woman experienced recurrent chest pain and new-onset hypertension. Her electrocardiogram (ECG) showed specific abnormalities, indicating potential cardiac issues requiring urgent evaluation.

Keywords:
ECGacute myocardial infarctioncoronary artery diseasewellens sign

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Area of Science:

  • Cardiology
  • Emergency Medicine

Background:

  • A 44-year-old woman presented with recurrent chest pain, diaphoresis, and nausea.
  • She had a history of heavy smoking and recently diagnosed hypertension (180/110 mmHg).

Observation:

  • The patient reported 45 minutes of chest tightening radiating to her left arm.
  • Recurrent episodes of chest pain occurred over 1.5 weeks, unrelated to exercise.

Findings:

  • The objective question asks to identify concerning findings on an initial ECG (Figure 1).
  • Potential ECG findings to consider include U-waves in precordial leads, biphasic P-waves in lead I, negative T-waves in aVR/aVL, or biphasic T-waves in V2/V3.

Implications:

  • Identifying specific ECG abnormalities is crucial for diagnosing acute cardiac events.
  • Prompt recognition of critical ECG findings can guide immediate management in the emergency department.