A 56-year-old female with diabetes reports dizziness, shortness of breath, and weakness that began an...

This is the kind of patient where EMTs should think beyond the absence of chest pain. In women, a myocardial infarction can present with less classic symptoms such as shortness of breath, dizziness/lightheadedness, and unusual weakness or fatigue . The American Heart Association specifically notes that women may have heart attack symptoms including shortness of breath and unusual tiredness and weakness , and the American Diabetes Association also lists shortness of breath and dizziness or lightheadedness among symptoms of heart disease that people with diabetes should recognize. ( www.heart.org )

So from an NREMT-style assessment standpoint, a 56-year-old woman with diabetes and a sudden onset of these symptoms should be treated with a high index of suspicion for acute myocardial infarction until proven otherwise. ( www.heart.org )