Authors: Stephen Ojo / Editor: Steve Corry-Bass / Reviewer: Raghaventhar Manikandan / Codes: / Published: 19/07/2022
A 79-year-old man presented with a fall and sustained bruising to his face and pain in neck. He is on regular medications for previous stroke (no residual weakness), Atrial Fibrillation and Hypertension. He was examined and appropriate imaging was undertaken, this was all normal. His Blood tests were unremarkable. His Vital signs showed a mild Tachycardia (Pulse of 92), EWS 1. A secondary survey showed no additional injuries.
He lives by himself and was admitted to Clinical Decisions Unit (CDU) to allow his pain to settle and ensure adequate mobilisation prior to discharge. He was prescribed PRN analgesia only.
He developed chest pain while on the observations unit and his heart rate was found to be 165bpm irregular. ECG showed atrial fibrillation with fast ventricular response and Ischaemic changes (ST depression ). He was referred to cardiology and treated for NSTEMI.
