Ischaemia and infarction
6 cases filed under ischaemia and infarction. Each opens on a tracing, asks what is on it, and ends with the reading worked through.
-
Central chest heaviness with nausea for ninety minutes
Smokes twenty a day. No regular medication and no rate-limiting drugs. Brought in by ambulance; the pain started while he was carrying boxes and has not eased. Gareth Whitlock is…
Work the case
-
Recurrent chest pressure at rest since early morning
Hypertension and dyslipidaemia. The first pain episode resolved before the ambulance arrived; the pain returned in triage. Pain is present during this recording. The initial…
Work the case
-
Central chest pain for forty minutes, still present
Smokes fifteen a day, no other history and no medication. Father died of a heart attack at 46. The paramedic tracing was transmitted and reported as no ST elevation, so he was…
Work the case
-
Epigastric pressure and nausea for four hours
Type 2 diabetes on metformin, hypertension on ramipril and indapamide. Ex-smoker. Seen at an out-of-hours clinic two hours ago and given omeprazole for indigestion; no ECG was…
Work the case
-
Sharp central chest pain for a day, worse lying flat
Fit and well, no medication. A week of sore throat, aches and fever that was settling until the chest pain began. Sent in by the university health service. The nearest primary PCI…
Work the case
-
Central chest pain for two hours, still present
Left bundle branch block documented three years ago during an outpatient work-up for breathlessness; no ischaemia found at the time. Hypertension on indapamide, type 2 diabetes on…
Work the case