False Pos cath lab activation

Computer read: ST elevation, consider early repolarization.

58 y.o. male presents to the stabilization room via EMS from the scene. Per EMS, the patient had a syncopal episode today. Past medical history significant for a valve replacement, patient does not know which heart valve). Patient denies any antecedent symptoms including chest pain shortness of breath. Patient denies symptoms at this time. However, EMS found the patient to be hypotensive. EKG in the field shows ST elevation in leads II, III, aVF. Patient given 324 mg aspirin PTA

Prehospital, time zero:

5 min

Pt arrived MM scarred. Resurvey intact. Patient given 324 mg ASA by EMS PTA.  prehospital EKG concerning for inferior STEMI. In the setting of syncope, unclear if there was transient third degree heart block or other arrhythmia. Patient has no symptoms now. However, repeat EKG is consistent with prehospital showing ST elevation in the inferior leads with reciprocal depression in aVL.

20 min

50 min

Cath Lab activated.  Therefore, patient given 600 mg Plavix as well as 4600 units of heparin.