> Sorry, loose nomenclature on my part - would be more accurate
> to talk of
> atypical chest pain:
>
> " ... the presenting symptoms of acute myocardial infarction in the
> elderly can be nonspecific. ... Neurologic symptoms,
> confusional states,
> weakness, and worsening heart failure are common clinical
> presentations
> of an acute infarction in elderly patients. Silent (unrecognized)
> myocardial infarctions are common in the elderly and carry serious
> prognostic implications."
Am I right in inferring from this that you do a lot of 12 leads in patients
without chest pain? I thought the original purpose of the ambulance 12 lead
was to identify patients for thrombolysis, so was relevant only in those
with chest pain ongoing or over 30 minutes duration; and under 12 hours
since onset. Are you doing fairly routine 12 leads now? I'm not saying it's
not a good idea especially if it doesn't delay transport; just that I didn't
think it was in most peoples protocols. (Just a thought: are you doing the
'pre-op' ECGs on patients with #NOF?)
Matt Dunn
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