Heartburn symptoms for a ...

The patient, a 54-year-old lady, arrived with heartburn symptoms. On routine examination, the patient reported minor chest tightness, lightheadedness, and bilateral radial pulses of 45/min. Her oxygen saturation on room air was 98%, her breathing rate was 18/min, and her blood pressure when sitting was 140/87 mm Hg. When the patient was in the worst pain possible, a 12-lead ECG was promptly completed (figure 1). In bigeminy of duplet and triplet, Premature ventricular complexes (PVCs) were paired with nodal complexes, but no evident ST-segment alterations indicated cardiac ischemia. Five minutes later, a second ECG was taken when the symptoms started to improve (figure 2). PVCs were still bigeminy, and there was only one duplet visible. A third ECG was taken when the patient reported that all her symptoms had vanished (figure 3). Take note of the PVC's continued bigeminy with nodal QRS complexes. Blood was also sent out to determine the serum troponin-I level after the patient reported feeling constricted in the chest.