04: Acute Coronary Syndrome: Case 1 Hamish
Hamish is a 75 year old retired fisherman from Aberdeen. He lives with his wife Flora who is 55 years old, she is a keen baker and Hamish finds it difficult to resist her sweet treats! He has been a smoker for 60 years and was diagnosed with type 2 diabetes 18 months ago. Hamish has recently taken up Scottish Country Dancing in an effort to lose some weight. He is aware of the age difference between himself and Flora and feels it has been more noticeable recently as he does not feel that he has as much energy as he used to.
Hamish has an appointment at his local GP Practice for his routine diabetic check. The practice is near his home so he always walks rather than take the car. Whilst walking to the surgery Hamish develops a pain in the centre of his chest which goes through to his back. It feels like “indigestion”, Hamish remembers the lovely pancakes Flora made for breakfast and wishes he had not had second helpings. Hamish mentions the pain to Iona the practice nurse and she notices that Hamish is looking much paler than normal she decides to perform a 12 Lead ECG, and requests that GP Dr Donald review Hamish.
A 12 Lead ECG is an important part of assessment and diagnosis, it is essential that it is acquired by a professional trained to do 12-lead ECG. Be aware of inaccurate lead placements as this may lead to inaccurate diagnosis.
Review Module 1 for technique for obtaining a 12-Lead ECG.