| Abstract: | A 77-year-old man presented to the emergency department with chest pain. Severe pain had occurred while he was walking, persisted for ten minutes, and was relieved when he took two nitroglycerine tablets. He had experienced intermittent chest pain for the past 11 days, mostly on exertion. The patient had hypertension, an elevated serum cholesterol level, and was a former smoker. His medications included aspirin, pravastatin, isosorbide dinitrate, metoprolol, and nitroglycerine.The patient was in no apparent distress and without chest pain when he was examined. His blood pressure was 154/88 mm Hg; pulse, 70 bpm; respirations, 18 per min; temperature, 36.8° C; and oxygen saturation, 97% by pulse oximetry. The physical examination was unremarkable. The ECG is shown. |
