Chest pain radiating to the back

Chest pain radiating to the back
Case introduction • A 64-year-old African American man is brought to the emergency department
for severe chest pain.
Initial vital signs • Pulse: 114 beats/min, Bounding
• Respiratory rate: 24/min
• Blood pressure, systolic: 192 mm Hg
• Blood pressure, diastolic: 94 mm Hg
Initial history • The patient experienced sudden, acute onset of left-sided chest pain that began
30 minutes ago while sitting at his desk at work. The pain is sharp and constant
and radiates to the back and left jaw. Nothing relieves the pain, which is rated
10 on a 10-point scale. He has not experienced this type of chest pain in the
past. He is mildly short of breath and nauseous.
• Past medical history of hypertension and hyperlipidemia.
• Family history, social history, and review of systems are unremarkable