Case #1

Mr. Smith, a 28 year old male presents in police custody complaining of chest pain. He has no other past medical history. No history of cardiac disease.

Patient further states that his chest pain began tonight about one hour after he was arrested by police. No history of trauma.

Social history=Smokes 1 pack/day. Occasional EtOH.

Family History= No cardiac deaths. MGM with Breast CA

• Physical Exam:
• Click HERE to observe the patient.
• General: Patient very agitated, clutching his chest.
• Vitals: P 140, BP 220/130 RR-28 Temp- 103.2F
• Eyes: Pupils 7mm, equal, EOMI
• Lungs: Clear Bilaterally
• Heart: Regular rate and rhythm, 2+/6 systolic murmur
• Abd: Soft, Non-Tender, BS+
• Neuro: No focal defecits.
• Skin: Diaphoretic
• ECG- Sinus Tachicardia, Large 5mm ST segment elevations in anterior leads. Unifocal PVC's, approx 2-3/minute.
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• CXR- (Click Here)

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