Reference no: EM133918735

Question

Mr. Agboka is a 49 year old man of African descent who is a schoolteacher. He is brought to the emergency department for evaluation of chest pain. He was shoveling snow from his driveway and finished half the work when he suddenly became short of breath and dizzy. He felt chest pain that he describes as "crushing and heavy" and ran down his left arm. He went inside, rested on the couch, and took two of his wife's nitroglycerin tablets. Mr. Agboka developed SOB with the chest pain which has increasingly become worse. The pain subsided somewhat, but his wife insisted on calling an ambulance. He is very upset and states "I know what it is. My dad died of a heart attack when he was 53 and now it is my turn."His wife takes you aside and tells you that he had been treated for hypertension, high cholesterol levels, and diet controlled diabetes but that he has refused medication for the past year. He eats what he wants and does not get much exercise during the school year. According to his wife, Mr. Agoka is 23 Kg overweight. She also tells you the he quit smoking last summer but started again in the past month.

When assessing chest pain presentation, what are descriptor words of concern that may be used by a patient when describing chest pain/discomfort and what would three differential diagnoses that you would be concerned with?