This is the chest pain MI registry case scenario for February of 2023. Our patient is an 84-year-old female with a history of hypertension, high cholesterol, and stent placement six months ago. She experienced nausea, chest tightness, and shortness of breath after receiving the shocking and sad news of the loss of a close relative. Her son called 911. EMS arrived at the patient's side at 6.53 p.m. and transported the patient to the closest facility. An ECG was performed at 6.58 p.m., and it was positive for STEMI. Upon arrival at the ED at 7.25 p.m., the ED physician reviewed the EMS ECG and requested the ECG be repeated. The on-call cardiologist was contacted at 7.26 p.m., and a code heart was activated per the on-call cardiologist. The ECG performed at 7.30 revealed a typical ST elevation, appearing mainly in the precordial leads. The patient was transferred to the cardiac cath lab at 7.55 p.m. based on the ECG finding and the patient's risk factors. The standard lab tests were ordered, but results were still pending as the patient was rolling out of the emergency department. Angiogram reviewed no occluded artery. The previous stent is patent. Medical management was decided based on Taketsubo cardiomyopathy by the cardiologist. Our question is, is this patient included in the chest pain MI registry? Number one, no. Or number two, yes. Please take a few moments to review the scenario and the question before making your final response. Is this patient included in the chest pain MI registry? The answer is number one, no. In this scenario, the patient was taken to the cath lab for reperfusion strategy. However, during the coronary angiogram, it was determined the patient was not experiencing a true STEMI, but rather Taketsubo syndrome. When at the conclusion of the episode of care, only the clinical diagnosis of Taketsubo remains, then the patient is not included in the registry. Let us review the rationale as to why the correct answer is number one. Patients greater than or equal to 18 years of age are included in the registry when a qualifying cardiac diagnosis is made on discharge. The registry has four qualifying cardiac classifications identified as the following patient types. STEMI, NSTEMI, unstable angina, and low-risk chest pain. At the conclusion of the episode of care, only the clinical diagnosis of Taketsubo remains. Therefore, the patient is not included in the registry. When the patient has a clinical diagnosis of both acute MI and Taketsubo on discharge, then the patient is included when the patient type definition and inclusion criteria are met. Thank you for viewing the chest pain MI registry February 2023 case scenario.

84-year-old female patient

chest pain

STEMI

Taketsubo syndrome

cardiac cath lab