Case 1

When 70-year old Joe Brown visited his wife in the hospital after her gallbladder removal, he had dinner in the hospital cafeteria. About a half-hour later, Mr. Brown developed severe aching pain in the middle of his chest and was experiencing mild nausea.

He immediately went to the emergency room, fearing a heart attack. His physical examination showed a pulse of 100 and BP of 146/88. The examination of his heart and lungs was normal and an electrocardiogram while he was experiencing the chest pain was unremarkable. He was given nitroglycerine, which reduced but did not completely eliminate the pain. Cardiac enzymes, creatine, Kinise and troponin remained negative.

Copyright 2000