▪️58 yo female, got up to use the bathroom in the night and states she “suddenly couldn’t breathe.” On EMS arrival pt is sitting comfortably, anxious but speaking in full sentences, skin is pink/warm/dry. She denies any chest pain and lung sounds are clear. 1+ edema to the lower extremities which is chronic but “a little worse.” Notably, pt recently had an ICU stay for NSTEMI and in her own words “they cleared out the blockage but didn’t do any stents, and they said I have another blockage still.” She is on furosemide, a beta blocker, and an anticoagulant.
▪️Room air SpO2 is 97% and pt remains pain free; 4-lead in the apartment is normal sinus with no ectopic. However, 12-lead EKG obtained is showing the above strip. IV access is obtained and pt is transported to the nearest ED (also PCI capable hospital) and an entry note requesting MD consult is made given the pt history despite the fact that her symptoms have resolved.
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