SOLVED735

what is the diagnosis:An 81-year-old woman presented to the emergency department with new onset left-sided chest tightness associated with nausea and vomiting. The chest pain radiated to her left arm and jaw. Her chest x-ray was within normal limits. The electrocardiogram exhibited sinus tachycardia with intermittent premature ventricular complexes, but no significant ST or T wave abnormalities. Complete blood counts were normal. A complete metabolic panel (including lipase and thyroid stimulating hormone) was normal. Her serum troponin T level (0.21 ng/ml) was elevated. Her past medical history was significant for hypertension, asthma, and hypothyroidism. Due to persistent chest pain unrelieved by morphine, aspirin, and sublingual nitroglycerin, she underwent coronary angiography. No significant coronary stenosis or calcification was noted during the angiography. A transthoracic echocardiography revealed a normal ejection fraction at 50-54%. After the procedure, we learned that the patient had been under a tremendous amount of stress due to her home burning down in a fire one week prior to presentation. She did not return to the clinic for follow-up.
SCIENCE
HEALTH SCIENCE
NURSING

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