Problem:
Clinical Presentation: A 67-year-old Laotian male with a history significant for HTN, stable angina, and type II DM is brought into the emergency department by ambulance after a sudden onset of severe retrosternal chest pain that began about 30 minutes ago while at work unloading boxes from a truck. He describes the pain as tearing sharp pain in between the shoulder blades and unrelated to movement. It was not relieved by 3 doses of nitroglycerin tablet. He has never had these symptoms prior to this episode, and reports that it feels "much different" than chest pain experienced in the past. His home medications include lisinopril 40 mg daily, Norvasc 5 mg daily, and metformin 1000 mg BID. He denies any surgical history. Upon arrival from EMS he appears extremely uncomfortable and appears to be of normal height and weight for age and gender. EMS reports that he is afebrile with heart rate of 118, blood pressure 156/100 mmHg in right arm and 200/94 mmHg in the left arm. Need Assignment Help?