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Scenario: Atypical Heart Attack


Please note: The users who submit scenarios have declared that all patient details are fiction. We cannot guarentee the accuracy of any suggested treatment or the realism of suggested observations. You should judge these for yourself.

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(Average: 5, Number of raters: 1)
Number of downloads: 1384
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Scenario Overview:
This scenario present an unusual set of symptoms from a heart attack and encourages students to consider atypical presentations. You are called to a woman sat outside who is flushed and sweating. She complains of having hot flashes and nausea and appears a little confused. She is with her friend, who called the ambulance. The patient insists that she does not need help.
Difficulty:
First Aider Difficult
How the scenario should progress:
The patient will initially be alert although a little confused. As the scenario progresses though, the patient will become more and more agitated and worried and will become unresponsive.
Patient 1:
Name: Lilly May    Age: 55    Sex: Female
Medication: Captopril (for hypertension)
Allergies: None Known
Past medical/family/social history: Hypertension, high cholesterol. Mum died after a heart attack when she was 61.
Findings on examination: Sweaty, flushed, nauseated, dizzy, 'feeling ill'. Dull back pain that is spread across the whole of the upper back. Nothing makes the pain better or worse although it does seem to be getting 'tighter' as time goes on. The patient hasn't been feeling great recently although the patient puts this down to stress because her husband isn't well and she has been busy looking after him. The patient appears fairly overweight. During scenario, the patient will try to stand but will feel very light-headed and immediately sits back down.
Possible treatment from first aiders: Good history. Request additional help (an ECG would probably be useful!). Reassess after change in response.
Time after start: 1 min 5min
Response: Alert Unresponsive
Airway: yes yes
Breathing? yes yes
Respirations: 14 regular 17 short
Pulse: 100 strong, slightly irregular 110 irregular
Oxygen Sats: 95 88
Blood Pressure: 155/96 160/99
Blood Glucose: 4.5 4.4



Tips for the patient actors:
Initially appear agitated and not wanting help but then become more worried throughout the scenario.

Scenario submitted by: Scenario Library