
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
Detailed Answer:
Hi,
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.
Regards


FOLLOW UP
Detailed Answer:
Hello again.
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.
Regards.
Have a nice day.

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