Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of substernal chest pressure radiating to the back/interscapular region, associated with diaphoresis, nausea, and dyspnea. Symptoms are persistent, non-pleuritic, and unresponsive to sublingual nitroglycerin. No history of recent trauma or gastrointestinal distress.
Clinical Examination Findings
Patient appears in acute distress, diaphoretic, and pale. Vitals: Tachycardic/Bradycardic, hypertensive/hypotensive. Cardiac: S1/S2 present, no murmurs, rubs, or gallops. Lungs: Clear to auscultation bilaterally. Extremities: No peripheral edema, pulses 2+ symmetric. ECG: ST-segment depression in leads V1-V3, tall R-waves, and ST-elevation in posterior leads (V7-V9).
Treatment Protocol
Immediate activation of Cardiac Catheterization Lab for primary PCI. Administer Aspirin 325mg (chewed), P2Y12 inhibitor (Ticagrelor/Clopidogrel), and anticoagulation (Heparin bolus/infusion). Initiate high-intensity statin therapy and IV nitroglycerin for pain control if hemodynamically stable. Monitor for arrhythmias and hemodynamic instability.