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Course: Acute Myocardial Infarction With Wide Complex Rhythm: What Is the Culprit Artery?

CME Credits: 1.00

Released: 2022-03-14

A man in his 70s presented to the emergency department with sudden-onset chest pain and profuse sweating, which had been persistent for 2 hours. His medical history was notable for hyperlipidemia but no other cardiac history. The patient’s heart rate was 88 beats/min, respiratory rate was 20 breaths/min, and blood pressure was 90/42 mm Hg. A 12-lead electrocardiogram (ECG) obtained at presentation is shown in the , A. The initial myoglobin level was 247.50 ng/mL (reference range, <154.9 ng/mL), creatine kinase MB isoform level was 2.2 ng/mL (reference range, <7.2 ng/mL), and serum high-sensitivity cardiac troponin I level was 0.0144 ng/mL (reference range, <0.0342 ng/mL). The repeated serum myoglobin level was more than 1200 ng/mL, creatine kinase MB isoform level was more than 300 ng/mL, and high-sensitivity cardiac troponin I level was more than 50 ng/mL.


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