Chest pain? Slap those leads on and run a 12 lead.
ST elevation? Lots of ST elevation? ‘Mother of God I think I just shit myself’ amounts of ST elevation?
Clean yourself up and calm yourself down before running a STEMI alert hot because there’s another possible answer for this mess of a 12 lead: Pericarditis.
Everyone is at risk for pericarditis. Everyone. But males between the ages of 20-50 are at higher risk. Looks like those of us with a vagina have the advantage once again.
So what is it? Let’s start with what it’s not. It’s not a STEMI. At all. It looks like a STEMI but then it doesn’t. With a STEMI you’re going to see the ST elevation limited to the infarct area. With pericarditis you’re going to see ST elevation everywhere. Fucking everywhere.
Pericarditis is the inflammation of the pericardium. You know, that sac that holds the heart. Yeah, that shit can get inflamed and man is it painful. It hurts a lot. And you’re patients are going to be complaining of substernal chest pain. It may or may not hurt worse when they breath.
There’s another magical way to tell if this is a STEMI or not too! Heart sounds! You all remember heart sounds, right? Time to put on your big paramedic stethoscope and listen for pericardial rubbing. You’ll know it when you hear it. It sounds like two pieces of leather being rubbed together.
Especially when your patient is young (anything under 20), think pericarditis. Is it possible for them to be having a real STEMI? Probably. Is it likely? No.
Critical thinking is your best asset as medical provider.