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Emergency Medicine News:
doi: 10.1097/01.EEM.0000433394.23022.00
Spontaneous Circulation

Spontaneous Circulation: Myocardial Infarction with Dual Culprit Lesions

Bruen, Charles MD

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Dr. Bruen is a fellow in critical care medicine and emergency cardiology at Hennepin County Medical Center in Minneapolis. He has special interest in stabilization, resuscitation, hemodynamic evaluation, and emergency cardiovascular care.

A 59-year-old man without prior cardiac history presented with three hours of severe upper sternal chest pressure that radiated to his throat, which he described as “strangulating.”

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An ECG was obtained, and is shown here. It demonstrates a sinus rhythm at rate of approximately 75 bpm. The PR and QT intervals are normal.

There is a concerning 1 mm of ST-elevation in V5 and V6 with ST-segment depression in V2 and V3, suggestive of a posterior myocardial infarction. What is your diagnosis?

Find the diagnosis, a complete case discussion, ECG interpretation, and the patient's outcome by reading Spontaneous Circulation in EMN's iPad App on Aug. 7 or in the Spontaneous Circulation blog at http://bit.ly/EMNblogPage, where additional EKGs are also available.

Click and Connect! Access the links in EMN by reading this issue on our website or in our iPad app, both available on www.EM-News.com.

© 2013 by Lippincott Williams & Wilkins

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