Hereâ€™s a case study from a faithful reader who wishes to remain anonymous.
Presenting Complaint â€“ Chest Pain
History of Present Complaint â€“ 58 year old female, nil cardiac history, mild smoker, social drinker and overweight.
Complaining of acute central chest pain @ rest. Awoken by pain.
On Arrival â€“ Sat upright on settee (Editorâ€™s note: One of you Brits will have to interpret that for me!)
Alert, orientated and communicable (GCS 15)
Pale, cool dry skin.
Nil SOB, clear bi-lateral air entry â€“ nil adventitious breath sounds
R/R 19, SpO2 99%
H/R 68 and irregular, BP 125/74
B.M 7.2 (Editorâ€™s note: B.M. is BGL measured in millimoles. 1 mmol/L of glucose is equivalent to 18 mg/dL. Hence, this patientâ€™s sugar is about 130).
C/O chest pain.
O â€“ Acute. Awoken from sleep.
P â€“ Nothing makes pain better. Not affected by breathing
Q â€“ Non specific compressing type pain
R â€“ Central chest pain radiating left arm
S â€“ Pain score 6/10
T â€“ 30 mins
I â€“ No pain intervention sought.
Slight nausea, nil vomit
The cardiac monitor is attached.
A 12-lead ECG is captured.
How would you treat this patient?