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The ECG is consistent with an inferior MI. The patient was transferred to the ED by ambulance after receiving ASA, nitroglycerin SL, and oxygen.
While MI is rare in patients under age 35, it should be considered when presentation is otherwise typical.
The most common causes of MI in young adults are hypercoagulable states and substance abuse (cocaine, primarily).
Acknowledgement: Case presented by Nahum Kovalski, BSc, MDCM, Terem Emergency Medical Centers, Jerusalem, Israel.
Clinical Challenge: June, 2009
Nahum Kovalski, BSc, MDCM
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