A 54-year-old man presented to the emergency department with central, crushing chest pain radiating to his left arm and jaw. The pain came on over 5 - 10 minutes after he had been running for a bus. He says the pain is 9/10 in severity and is associated with nausea and shortness of breath. Patient History: His medical history includes hypertension and type 2 diabetes mellitus. He has smoked 20 cigarettes per day for 30 years. His regular medication includes aspirin, ramipril, and metformin. Physical Examination: This man is overweight and visibly uncomfortable.
His heart rate is 100/min and blood pressure 140/88 mmHg. He was given 300 mg of aspirin and a glyceryl trinitrate (GTN) spray by the paramedics, which eased the pain. An ECG was performed, which was normal excluding an ST-elevation myocardial infarction. What do the symptoms suggest? What can be done for this man acutely? *This…
