A 50-year-old man who is profusely diaphoretic and hypertensive complains of crushing substernal cheat pains?
1. Rule out acute coronary syndrome (ACS)- Electrocardiogram (ECG)
- Cardiac biomarkers (e.g., troponin)
2. Consider other potential causes of chest pain
- Aortic dissection
- Pulmonary embolism
- Pericarditis
- Gastrointestinal causes (e.g., esophageal spasm)
- Musculoskeletal causes (e.g., costochondritis)
3. Initiate treatment based on suspected diagnosis
- ACS: aspirin, clopidogrel, morphine, nitroglycerin, oxygen
- Aortic dissection: immediate surgical intervention
- Pulmonary embolism: anticoagulation, oxygen, vasodilators
- Pericarditis: NSAIDs, colchicine
- Gastrointestinal causes: antacids, proton pump inhibitors
- Musculoskeletal causes: analgesics, heat/cold therapy
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