Acute, Severe Chest Pain in the Presence of Known Coronary Artery Disease: New Myocardial Ischemia, Aortic Dissection, or Some Other Evolving Cardiovascular Catastrophe?

A 72-YEAR-OLD, 99-kg, 170-cm man was transferred to the authors’ institution from a community hospital for evaluation of new, severe, stabbing chest pain radiating to his back. The patient’s pain began suddenly at his home and was accompanied by dizziness, palpitations, diaphoresis, dyspnea, and nausea. He acknowledged a history of coronary artery disease and stated that he previously underwent coronary stent implantation more than a decade before the current admission. His past medical history was notable for chronic atrial fibrillation, hypertension, hyperlipidemia, tobacco use, and an abdominal aortic aneurysm for which he was followed with serial imaging studies at another facility.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Diagnostic Dilemma Source Type: research