Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of typical anginal chest pain, described as [pressure/tightness/crushing], radiating to [jaw/left arm/back], associated with diaphoresis, nausea, and dyspnea. ECG reveals new or presumably new Left Bundle Branch Block (LBBB) with Sgarbossa criteria met (concordant ST elevation ≥1mm in leads with positive QRS; concordant ST depression ≥1mm in V1-V3; or discordant ST elevation ≥5mm in leads with negative QRS). Symptoms began at [Time].
Clinical Examination Findings
General: Patient appears in acute distress, diaphoretic, and tachypneic. Cardiovascular: Tachycardic/Bradycardic, S1/S2 present, no murmurs, rubs, or gallops. Lungs: Bilateral crackles noted at bases, suggestive of acute heart failure. Extremities: Cool, clammy, no peripheral edema. Neurological: Alert and oriented, no focal deficits.
Treatment Protocol
Immediate activation of Cardiac Catheterization Lab for primary PCI. Administered Aspirin 325mg (chewed), P2Y12 inhibitor (loading dose), and UFH bolus. Initiated IV Nitroglycerin for pain control and titrated for BP management. Monitoring for hemodynamic instability; prepared for potential transvenous pacing or mechanical circulatory support.