What causes constant retrosternal chest pain lasting for few minutes?
I am a nursing student doing an assignment and want to know what diagnosis a patient will be if he is 42 with retrosternal chest pain that's constant, dull in character, with intermittent stabbing episodes lasting a few minutes. Theres no nausea, sweating or vomit but he is pale in colour with dysnopea. He also has inverted t waves on the ecg but a normal chest xray. I suspect he has a pulmonary embolism or pneumothorax??? as he is obese with a 10 year smoking habit. He has a family history of hypertension and has had gall bladder surgery and spinal laminectomy
ADVICE REGARDING CHEST PAIN
Thank you for posting your query in HCM
This is Dr. Swarnava Dattagupta answering your question.
I appreciate your question and your curiosity regarding this case.
See, from the features and the ecg reports, it seems like a case of myocardial ischemia. Also pericarditis can be the diagnosis from the ecg. Pulmonary embolism is a possibility too due to inverted t wave. For that a bedside cardiac echo might help.
Pneumothorax is ruled out from the normal x-ray findings.
I would ask you to do the following-
Do a repeat ecg
If 6hours have not passed, do a TropT and check the results.
Contact me with the results so that i can tell you further.
Hope I have answered your query.
Thanks that i could lead you to a diagnosis.
I gave you an idea about what followups are to be done in such a case.
You can add them to your case study.
Have a nice day.
The User accepted the expert's answer
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