A 76 year-old African-American female with a history of hypertension, type II Diabetes Mellitus, hyperlipidemia, and gatroesphageal reflux presented to emergency room complaining of epigastric pain radiating to left substernum which started the night before presentation. The onset of her sharp pain was at rest, lasted for two hours, and was aggravated by eating and drinking. Her chest pain was followed by gagging and regurgitating of liquid contents. Her chest pain was non-exertional, and not associated with shortness of breath, diaphoresis, nausea, or vomiting. In the Emergency Department, her pain subsided with two sublingual nitroglycerins and 2 milligrams of intravenous morphine. On further questioning the patient stated that the pain had been intermittent for two months. She had seen her outpatient doctor one week prior to admission, who recommended rantidine and an outpatient stress test.
Farmer, MD, Nicole and Cohen, MD, Michael
The Medicine Forum:
Vol. 7, Article 19.
Available at: http://jdc.jefferson.edu/tmf/vol7/iss1/19