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 Case
#28 Right Side/ Back Side
A 62 y/o female arrives at the ED with chest
pain for two hours, described as burning,
indigestion and is associated with mild
shortness of breath. She has had this
before, but never sought medical attention.
She has a history of mild hypertension, and
borderline diabetes (diet controlled).
PMH: No heart/lung/abdominal problems. No
surgeries except gall bladder surgery ten
years ago.
SH/FH: No smoking, no family history of
heart disease before age 60. No allergies.
PE: WD obese female, in no acute distress.
150/85, HR=92, RR=20, afeb., Sat 96% RA
HEENT: No JVD, unremarkable
Heart RRR, no murmurs, gallop.
Lungs: Clear, no rales, no wheezing
Abd: Obese, non-tender. Cholecystectomy
scar.
Ext: No edema, good pulses.
Rectal Guaic neg, unremarkable.
Per protocol, the nurse hands you this EKG
that was done just before you walked in to
see the patient (link
to the EKG).
1. What is the diagnosis and what do you
need to do?
2. Would a right sided EKG be helpful? How
do you interpret it?
3. Would a posterior EKG be helpful?
4. What medication is contraindicated in
right sided infarcts?
Click here for answers and to respond
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