Case 36-2011: A 93-Year-Old Woman with Shortness of Breath and Chest Pain

A 93-year-old woman was seen in the emergency department because of a 3-hour history of chest pain and shortness of breath. An electrocardiogram showed ST-segment elevations. A diagnostic procedure was performed. Presentation of Case Dr. Pooja Agrawal (Emergency Medicine): A 93-year-old woman was seen in the emergency department at this hospital because of chest pain and shortness of breath. The patient had been in her usual state of health, with hypertension and chronic renal insufficiency, until the morning of admission, when she was awakened by stabbing substernal chest pain that radiated to the left shoulder and jaw and was associated with shortness of breath. She called emergency medical services; on evaluation, an electrocardiogram reportedly showed ST-segment elevations. Acetylsalicylic acid was administered orally, and nitroglycerin was given sublingually (three doses). She was . . .