Country cardiograms case 14
Hugh Hindle, MB BS, CCFP
CJRM 1999;4(4):236
The RNs have just voted to go on strike; every stable patient in the hospital has to be sent home. As chief of staff, it is your job to make the call about who can be discharged. You are reviewing the following case:
Mrs. Burnett (not her real name) is a 63-year-old woman who was admitted 4 days earlier with a 30-minute history of typical ischemic chest pain. The pain settled with the administration of oxygen in the Emergency Department and did not recur as she began to move about. Her initial ECG showed poor R-wave progression but no features of acute ischemia. She has managed to climb a flight of stairs without the recurrence of any symptoms. Serial creatine kinase estimations were normal. Her physician has treated her with Aspirin, beta-blockers and heparin intravenously. You can tell that her ECG has become progressively more abnormal during her admission. The current ECG is shown below.
Is it safe to send Mrs. Burnett home?
See page 242 for the discussion and answer.
Hinton Medical Clinic, 102 Allen Cove, Hinton AB T7V 2A6
This article has been peer reviewed.
"Country cardiograms" is a regular feature of the Canadian Journal of Rural Medicine. In each issue we will present an electrocardiogram and discuss the case in a rural context. Please submit cases to Ms Suzanne Kingsmill, Canadian Journal of Rural Medicine, Box 1086, Shawville QC JOX 2Y0.
© 1999 Society of Rural Physicians of Canada
