Case 2

A 55-year-old lady presents to the Emergency Department with a two hour history of chest pain. 

She reports that it came on suddenly, is ‘like a pressure’ in nature, radiates to both shoulders and is associated with breathlessness. She has been getting similar pains over the preceding month which she has attributed to indigestion. 

She has no risk factors for ischaemic heart disease or venous thromboembolic disease. 

On examination she is tachycardic and tachypnoeic but has no other specific physical signs. 

Her pain has settled by the time you assess her.