Case — Chest Pain cover art

Case — Chest Pain

Case — Chest Pain

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Identifying information
62-year-old man with hypertension, hyperlipidemia, and a 40-pack-year smoking history (quit 2 years ago) who presents to the ED with 2 hours of substernal pressure.
History of present illness
The pain started at rest while he was sitting on the couch watching television. He describes it as a heavy, squeezing pressure under the sternum, intensity 7/10, radiating into the left arm and jaw. It is associated with diaphoresis and mild dyspnea. There is no relief with rest or change in position. He has not taken nitroglycerin (none at home).
Over the past 3 weeks he has had similar but milder episodes that occurred only with exertion (walking to his truck, climbing a few stairs) and resolved within a few minutes of rest. Tonight is the first time the pain has occurred at rest and lasted this long.
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