ECG #6: Inferior STEMI

At around 1am, I solo responded to a man experiencing chest pain and SOB. I always find the less details on the MDT, the more serious the incident – I guess because the caller isn’t relaxed enough to be forthcoming with detailed information other than ‘just get here quickly!’.

This 60 year old chap was laying in the middle of the hallway of an upstairs flat, with his partner by his side. He looked in pain and worried enough for me to stick on the sats probe (O2 or not? is normally my first question) and head straight for the 12 lead.

Fairly obvious and nailed on. Check out the interesting non-elevation / depression in lead V2 suggests it’s more likely the R side was involved. Sure enough the VR4 confirmed, with a dropping BP from initially 136/84 to 114/70 about 15 minutes later.

Obviously aspirin and nitrates are a part of the care package here. Doing my contraindication checks, when I get to seeing if this chap had sildenafil…viagra, he goes quiet. And then tears up and says yes, and asks his partner for forgiveness. Poor dude. I tell him everyone and his aunt is on ‘the blue pill’ these days and it’s lost it’s stigma. Anyway I tell him that it helps with keeping the blood vessels nice and relaxed so this may have helped him avoid the more harmful effects of an MI!

We wheel off the teary patient down to the ambulance amoung reassurances from his partner. The cath lab confirms an RCA occulsion. I silently salute the heroic blue pill, saving lives in more ways than one.