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Mr. Jackson went to the cardiac intensive care unit at 2:45 pm. A transvenous pacing catheter was inserted and he was paced on demand. His cardiac rhythm showed ventricular pacer spikes at the rate set by the pacemaker for the first several hours after. He then converted to a NSR at a rate of 88 with PVCs at 8:15 pm. His BP was 102/74. His lungs remained clear to auscultation, but he had marked jugular venous distension. He developed a S3. His extremities were warm and well perfused. Serial ECGs, cardiac biomarkers, and coagulation studies were ordered. His CK-MB, total CK, and troponin continued to increase. By the next morning Mr. Jackson’s condition had stabilized. He was in NSR with 1-2 PVCs per minute with the Lidocaine infusing at 2 mg/minute. His BP was 130/100. Captopril was initiated at 12.5 mg po tid. At 6:00 am his total CK Was 2157, his CK-MB was 419/6.8%, and Troponin 0.3. His 12 lead ECG no longer had ST elevations in leads II, III, AVF, and V1-V6. A stool softener was ordered to be given daily. A day later, he obtained an ECHO and his ejection fraction was 56%. The Lidocaine was discontinued.7.
SCIENCE
HEALTH SCIENCE
NURSING

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