12 year old Duchennes MD ( spontaneous mutation) who is chairbound for 3
years attends Ped ER with chest pain 4 hours after eating a doughnut on his
birthday. A stir fry was eaten by the whole family the night before and
everyone else in the house is well.
His mum is concerned he has dyspepsia but it has not settled on over the
He is not on regular medication and has no known allergies.
No family history of sudden death, IHD, hyperlipidaemia etc.
In the dept while having an EKG his condition worsens. He becomes
increasingly anxious. He denies palpitations.
Immediately after being given gaviscon he vomits partially digested food and
feels immediately better.
His ECG has an infero anterior ishcaemic pattern.4 mm depression V1, 3mm
V2,St elevation of 5 mm on 1,2, 3mm on 3 and avF and 2 mm dep on avR
His first BP is low ( sys 70) but with an appropriate sized cuff it is in
within normal limits ( sys 110) for his age and weight. There is no
dysparity in the arm BP and there is no radio-femoral delay
What next folks?
Paediatric Emergency Department
Bristol Children's Hospital
St. Micheal's Hill
University Hospital of Wales
Say Bye to Slow Internet!
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is: