Author: Joel Davis / Editor: Yasmin Sultan / Reviewer: Eugene Henry / Codes: A1, O4 / Published: 20/01/2021
An 84-year-old gentleman attends ED with a 48 hour history of tight central chest pain on exertion. It radiates to both shoulders and is associated with a worsening of his usual shortness of breath. He has no nausea, sweating, cough, sputum or haemoptysis.
He takes warfarin for PE/DVT and AF, and has recently been started on anagrelide and pipobroman for essential thrombocythaemia. He is a diet-controlled diabetic and has never smoked. He also mentions a painful ulcer on the inside of his lower leg.
His vital signs are BP 138/60, HR 82 and SpO2 99% on air.
Initial bloods show Plts 572, INR 2.9, and no other marked abnormalities. Troponin is awaited. His ECG is shown below.
