HPI: 61 year old male with significant cardiac risk factors presents with chest pain that that radiates down both arms. The pain is exertional and improves with rest. His pain is associated with nausea and diaphoresis.

Vitals: HR-50, SBP-90s, RR-18, SpO2-98%

Exam: Clear lungs, regular bradycardia, otherwise normal.

Case ECG












Before watching this week’s video, ask yourself these questions:

  1. What are the concerning historical features that increase or decrease the likelihood that this patient is having an acute coronary syndrome (ACS)?
  2. What is the rate and rhythm of the ECG above?
  3. What other abnormalities can you identify? Does the patient meet cath lab criteria?
  4. What should you do if the patient’s symptoms are not improving or changing?


Case Interpretation

Review ECG Interpretation
Review Key Teaching Points



Thanks to Dr. Daniel Kwan (PGY-3 EM resident at UCSF Fresno) for sending this weeks case!

Notes: Questions for Amal? Email him at amalmattu@comcast.net or find him on Twitter @amalmattu.