Acute M.I. (presenting with severe SOB)

For the dyspneic patient in extremis, suspect Acute M.I. if:

  • Lung auscultation: bibasilar rales, or clear lungs
  • Risk Factors: man >40 / post-menopausal woman, hypertension
  • Exam:  Looks gray & ashen.  If available: EKG [S-T elevation]
  • Seek Recent Symptoms (if able to obtain additional history):
    • chest pain / pressure (left shoulder, upper arm, jaw)
    • nausea/vomiting, diaphoresis, lightheadedness.
  • Seek Past Medical History:
    • diabetes, hypertension, smoking, hyperlipidemia, cocaine/amphetamine use, Hx of exertional chest pain.
    • DON’T FORGET patient’s allergies & medications
Stabilizing Treatment
  • Call 911.  Give O2.
  • Aspirin 325 mg p.o.
  • Have Automatic External Defibrillator available.

See posting Acute Dyspnea – 1.