A 70 year old male presents to majors with central chest pain, which radiates to the left side.

This pain began suddenly on exertion and has radiated to his jaw with some shortness of breath. He has also begun to sweat. He has taken his GTN on commencement of the pain but got no response. A passer-by called 999. The paramedics administered aspirin and morphine on arrival. His pain score is now 2/10.

Questions

Answer one question before attending the face-to-face teaching session. Add comments to answers already given if you think it's appropriate. The first part of teaching will be spent discussing this case:

  1. What is the likely diagnosis?

  2. What are the changes on the ECG?

  3. Who in the ED can assist you with this patient?

  4. What area of the ED would you assess them in?

  5. What will be your management in the ED?

  6. Where will the patient be admitted to and how will you arrange that?

  7. How does aspirin work?

  8. How does Clopidogrel work?

  9. How does LMWH work?

  10. If his initial ECG and troponin were normal, what is his ‘Initial NSTEMI GRACE’ score (Age 70yrs, HR 95b/m, SBP 180 mmHg, Creat 122) and what are the implications for the patient's prognosis?

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