Common cases in cardiology: chest pain
This article describes the approach to the ward round in our fourth patient, Mr Jones, who has chest pain
Mr Jones is 59 year old man who was admitted to hospital overnight because of a six hour history of chest pain. He was seen by a junior doctor in the emergency department and moved to the cardiology ward. He is waiting to be reviewed by the cardiology registrar who was attending another patient when Mr Jones first arrived in the emergency department. You review his notes before the morning ward round.
You look at the plan in the notes and see that Mr Jones has been started on treatment for suspected acute coronary syndrome.
Mr Jones has been diagnosed as having acute coronary syndrome. This suggests he has a compromised blood flow to the heart that will result in myocardial ischaemia or infarction if left untreated. Acute coronary syndrome can also cause adverse haemodynamic effects such as cardiac arrest, so it is crucial to reduce the heart rate and