Barbara Davis

A 52-year-old woman presents to the emergency department with acute, severe central chest pain radiating to her jaw and left arm, with sweating, nausea, and a sense of impending doom. Take a focused history, perform a relevant examination, and initiate appropriate management.

1. 1Take a focused history of the chest pain including SOCRATES and cardiac risk factors
2. 2Identify cardiac and non-cardiac differentials
3. 3Perform a focused cardiovascular examination by thinking aloud
4. 4Order and justify appropriate investigations (ECG, troponins)
5. 5Provide a working diagnosis and assess severity
6. 6Initiate acute STEMI management including pharmacological and reperfusion options
7. 7Arrange appropriate referral, admission and safety-netting