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Middle-Aged Women Found Down: Seen in the ED
The patient shows no signs of trauma but is a poor historian so no further details are available. Do her vitals or ECG provide any clues to a Dx?
Brady Pregerson, MD
History of present illness: A woman in her mid-50s is transported from the streets to the emergency department (ED) after being found down without evidence of trauma in front of a business. She is a poor historian and is unsure if she might have fainted or just fallen asleep. She denies chest pain or other complaints but seems quite sleepy.
Vital signs and physical examination:
- Heart rate: 52 beats/min
- Blood pressure: 115/73 mm Hg
- Respiratory rate: 12 breaths/min with O2 saturation of 94% on room air
- Neurologic examination is nonfocal but she is uncooperative and so it is limited.
- ECG findings are shown here
Computer Read: SB with first degree AV block, moderated IVCD, ST elevation c/w injury, pericarditis or early repol, nonspecific ST and T wave changes
What should you do next?
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