Fooled again

I can't honestly say that I've seen everything. There are plenty of things in life in general and as a paramedic in particular that I've not seen (some that I hope never to see!). This week was another one of them. We were called to a male in his late 20's with chest pain. As many paramedics will tell you a call like that tends not to be life threatening. It might be a cold, chest infection, muscle pain. But very VERY rarely does it tend to be anything heart related. The call was in the early hours of the morning, the patient had been out drinking all night, was very vague when asked about any drugs taken. All pointing away from cardiac problems. He then went to give all the symptoms that kept leading us away from a cardiac diagnosis. Even his ECG was near on perfect. Then we got to hospital. And his ECG changed dramatically! What was even stranger was that it was different depending on whether he was sitting or lying. Again leading away from a diagnosis of an MI (heart attack). But just in case we were asked to convey him to our nearest Cath Lab. This is where an angiogram (which gives you a look at the blood vessels of the heart) can be performed and if necessary angioplasty. This is where a blocked coronary artery (the basic definition of a heart attack) is opened with a balloon and a stent left in place to keep it open. Even the doctors at the Cath Lab were fairly dubious that this patient was having an MI, but nevertheless performed the angiogram. Which is when you saw about a dozen jaws hit the floor. There on the screen appeared the largest blood clot I have ever seen in a coronary artery. This 20 something year old was having a heart attack. He was going to spend the rest of his life on medication. He would probably not be allowed ever to go on a rollercoaster. I know that sounds like a ridiculous thing to say. But it's always the little things that are the most missed. Remided me of just how mortal we all are. And also how I ain't seen nothing yet.