Course: A Peculiar ST Elevation Mimicking STEMI
CME Credits: 1.00
Released: 2022-12-27
A patient in their 60s presented to the emergency department with a 2-week history of shortness of breath and back pain exacerbated that morning. The medical history was noteworthy for a remote history of cervical cancer. The patient was recently found to have a vesicovaginal fistula and metastatic lesions in the liver and lungs. Percutaneous bilateral nephrostomies were placed weeks before presentation. The patient also had a history of 40 pack-years of smoking but no known cardiovascular disease. On admission, blood pressure was 105/65 mm Hg, heart rate was 94 beats per minute, and respiratory rate was 16 breaths per minute. Jugular veins were mildly elevated, and cardiac examination was notable for a gallop and a soft systolic ejection murmur. Lung examination demonstrated basilar crackles, and there was grade 2 and higher lower-extremity edema. A 12-lead electrocardiogram (ECG) was performed on arrival ().
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