Why does this male patient in early 50s with 3 months of exe | Figure 1
forderit
Emergency Medicine
Case Summary
Why does this male patient in early 50s with 3 months of exertional chest pain and history of previous MI attend your ER today and has a normal troponin two hours after his last chest pain? Would a highly suggestive EKG and a convincing risk profile warrant immediate ACS treatment while the patient is pain-free and repeat troponin is pending?
Update 1
The reason this high-risk patient has finally attended today is the severity of pain on this occasion. This time the patient was reluctantly brought by their partner who thought something’s not right on this occasion. First troponin (2hrs) was normal, but subsequent readings were in the hundreds. Take home lesson: your partner can save your life!
Diagnosis Added
NSTEMI