Doctor's Notes

Patient alert and oriented. Pain reduced from 9/10 to 4/10 post Morphine. BP improving — 100/68 mmHg. HR 98 bpm. Sinus tachycardia on monitor. Troponin I critically elevated — 28.4 ng/mL. ECG shows ST elevation V1-V4 consistent with anterior STEMI. Plan: Emergency PCI — cath lab booked 11:00 hrs. Patient and family counselled. Consent obtained.

62F presenting via ED with severe central crushing chest pain radiating to jaw and left arm. Duration 90 minutes. Diaphoretic. BP 90/60, HR 110. SpO₂ 88% on air. 12-lead ECG shows anterior STEMI (V1-V4). Activate cath lab — emergency PCI pathway. IV access, O₂, heparin, DAPT loading initiated. Bedside echo — anterior WMA, EF ~35%. Cardiogenic shock component — commence GTN carefully, monitor BP. NBM for procedure.