Which of the following patients would MOST need rapid intervention to correct cardiovascular compromise?
A) A 70-year-old female with chest pain. She describes acute onset while walking upstairs, pain described as below her right breast, sharp and radiating to her abdomen. Medical history includes myocardial infarction and type II diabetes. HR = 102, BP = 102/60, RR = 14, SpO2= 98%.
B) A 72-year-old male presents supine in bed, pulseless, and apneic. Family members state he was last seen the night before when he went to bed. Physical examination reveals cold, dry skin. ECG reveals asystole in three leads.
C) A 63-year-old male in severe respiratory distress. Physical examination reveals rales bilaterally through the upper lobes, skin cold and diaphoretic with peripheral cyanosis, head bobbing, JVD, and peripheral edema. HR = 133, BP = 76/42, RR = 30 and shallow, SpO2 = 89%.
D) A 56-year-old male complaining of acute-onset chest pain while at a casino. Physical examination reveals cool, diaphoretic skin and lungs clear. A 12-lead ECG reveals ST depression in V1-V3. HR = 112, BP = 146/102, RR = 14, SpO2 = 97%.
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