SUBJECTIVE
The patient is a 64-year-old Caucasian male with substernal chest pain on exertion for 1 month prior to admission. The night before admission, there was a particularly severe pressuretype substernal chest pain that radiated to the neck and lasted 20 minutes with associated diaphoresis. Cardiac risk factors include 30 pack-year history of smoking, family history positive for hypertension. According to the medical records provided by his family physician, the patient was placed on diltiazem 60 mg q.6h., Isordil 60 mg t.i.d. and aspirin 325 mg daily.
1 answer
The patient's subjective symptoms of substernal chest pain, radiating to the neck, and associated diaphoresis are concerning for possible cardiac issues. His history of smoking and family history of hypertension further increase his risk for cardiovascular disease. The fact that the chest pain occurred on exertion and lasted for 20 minutes is particularly worrisome. The medications he has been prescribed by his family physician suggest that he may already be on treatment for possible cardiac issues. Further evaluation and testing should be done to assess the severity of his condition and determine the appropriate treatment plan.