A 35yearold female comes into the ER complaining of periodic

A 35-year-old female comes into the E.R. complaining of periodic sudden severe chest pains that last about 3-5 minutes. She also complains that she is feeling squeezing and pressure in her chest. She tells you that the last couple days she felt nauseous, tired, and has been having trouble breathing.

What are three possible diagnoses?

What tests would you run and what results might you expect to see?

Why are you seeing the signs and symptoms that occur? Explain the pathophysiology.

What is the best diagnosis and why did you discard the other options?

Solution

The symptoms are suggesting Myocardial infarction because she is feeling squeezing and pressure in her chest. This is sign of heart attack. This is also firmed by periodic sudden severe chest pains which are stayed for 3-5 minutes. The feelings of tiredness, nausea and troubled breathing from few days were making the disease.

The other options can be taken Momentary chest discomfort, Pinpoint chest discomfort and Chest discomfort. But the first two options are related to inflammation of chest and do not comprise with a feeling of pressure in chest. The third (option) condition gets better if an exercise is performed.

Cardiac troponin ST elevation or depression waves or coronary intervention are the tests taken to diagnose Myocardial infarction. Also if the patient feels ischemic-type chest pain for 20 minutes many times during his life with serial ECG tracings changes and serum cardiac biomarkers rises and fall, the patient is certainly having Myocardial infarction.

Atherosclerosis is the most common way to develop the Myocardial infarction. In Atherosclerosis cholesterol and fibrous tissue get accumulated in the wall of arteries in the form of plaques. Inflammation and calcification lead to develop plaques. Atherosclerotic plaque is disrupted in an artery which leads to clotting and then artery blockage. The ruptured artery wall cannot develop adequate electrical signals which make less fictional heart.