Published Online: May 17, 2007 - 11:48:21 PM (CDT)
Proddutur Raghuveer Reddy, MD Cardiology Fellow
Thomas McKiernan, MD Associate Professor of Medicine Division of Cardiology Loyola University Medical Center Chicago, Ill
Question A 54-year-old man with a history of polysubstance abuse presented to the emergency department with a chief complaint of left-side chest discomfort. The pain was worse when he was lying on his left side and was not associated with any other symptoms. The patient reported that he had last used cocaine 4 days ago. His blood pressure was 124/78 mm Hg and pulse, 89 beats/min. His medical history was significant for hypertension but he has not been taking medication. He was given 325 mg of chewable aspirin and 1 inch of topical nitroglycerin paste. A 12-lead electrocardiogram (ECG) was obtained (Figure 1).
