Mr. Raymond's chest pain
 
Symptoms & History

Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

Mr. Raymond's new EKG is definitely abnormal.
  • ST depression
  • This is evidence of sudden cardiac ischemia.
What other bit information from this episode of pain suggests cardiac compromise?

Clearly Mr. Raymond is having cardiac ischemia and could be ready to have an infarction or arrhythmia. He is given a sublingual nitroglycerin 

  • Within a few minutes his chest discomfort is gone.
  • However,  he now says he has a mild headache. (Why?)
What needs to be evaluated now?
 

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