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.