Chest Pain

What are your stories of patients coming in with chest pain?

I was presented with a 60yo male last week who reported 4/10 pain in his chest, slight shortness of breath during the day and weakness in the arms. The pain felt like a lump in his chest and he is known to have a significant history of indigestion.

I trialled some mylanta and did an ECG and here I was looking at a man with what seemed to be a minor MSK chest pain reporting significant ST elevation in the posterior leads of his ECG.

I had no idea how this was managed in the GP setting but I did everything I needed to do whilst the ambulance was being called. What a rush! Oxygen on despite normal sats. GTN spray and aspirin given. IV cannula in and morphine pushed through. When the ambulance arrived there was still some ST elevation and we sent him on his way to the cath lab.

The next day after the weekend I found out he had 2 stents put in and is awaiting bypass surgery. What do you know. A life saved. Sometimes it’s better to go with your gut and look because more things are missed by not looking than not knowing.

This is the first time I had to transfer anyone to hospital but boy was it a rush. Let me know if you have any misleading presentations of chest pain yourselves.

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