60-Year-Old Man With Chest Pain

Gami, Apoor S.; Jaffe, Allan S.
March 2004
Mayo Clinic Proceedings;Mar2004, Vol. 79 Issue 3, p399
Academic Journal
A 60-year-old man was admitted to the coronary care unit with chest discomfort. Two weeks before admission, he experienced exertional dyspnea and orthopnea that required him to sleep upright in a chair. At that time, electrocardiography revealed new atrial fibrillation, and digoxin, furosemide, and warfarin were initiated. At 3 A.M. on the day of admission, while at rest the patient experienced acute onset of constant left parasternal pressure of moderate to severe intensity. It was nonradiating, unaffected by exertion, and unassociated with other symptoms. The patient's history included hyperlipidemia and a stroke.


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