Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of substernal chest pressure radiating to the back/interscapular region. Associated symptoms include diaphoresis, nausea, and dyspnea. ECG reveals ST-segment depression in leads V1-V3, with posterior leads (V7-V9) demonstrating >0.5mm ST-segment elevation, consistent with acute posterior wall myocardial infarction.
Clinical Examination Findings
Cardiovascular exam: S1/S2 present, no murmurs, rubs, or gallops. Peripheral pulses are symmetric. Lungs: clear to auscultation bilaterally. Extremities: no peripheral edema. ECG findings: ST-depression in V1-V3, positive posterior leads (V7-V9) with ST-elevation. Cardiac biomarkers: elevated troponin I/T.
Treatment Protocol
Immediate activation of Cardiac Catheterization Lab for primary PCI. Administered loading dose of DAPT (Aspirin 325mg and P2Y12 inhibitor), anticoagulation (Heparin protocol), high-intensity statin, and beta-blocker therapy. Monitoring for hemodynamic instability and arrhythmias.