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Case Study # 2 A 69-year-old male is seen in the emergency department complaining of chest pain. The pain is located on the left side of his chest and he describes it as a sharp pain, which lasts 30-40 minutes and then subsides. He has been awakened three times in the past week because of the pain. He reports that he first experienced the pain approximately 6 months ago. However, at that time he was experiencing the pain only once in a while and usually while doing his gardening. His medical history is only significant for hypertension, which was first diagnosed 25 years ago. He smokes half a pack of cigarettes per day and has done so for the past 45 years. Both his father and two of his brothers died from heart disease. There is no other significant family history. P.E. Findings General: 69-year-old male, no acute distress Vitals: BP – 154/92 mmHg PR – 68/minute Temp – 98.2F RR – 16/minute Neck: No JVP noted No hepatojugular reflux noted No carotid bruits appreciated Cardiovascular system: Precordium normal shape and size No abnormal pulsations appreciated No tenderness to palpation No thrills or heaves S1, S2 heard, no murmurs Respiratory system Clear breath sounds on all lung fields

Case Study # 2 A 69-year-old male is seen in the emergency department complaining of chest pain. The pain is located on the left side of his chest and he describes it as a sharp pain, which lasts 30-40 minutes and then subsides. He has been awakened three times in the past week because of the pain. He reports that he first experienced the pain approximately 6 months ago. However, at that time he was experiencing the pain only once in a while and usually while doing his gardening. His medical history is only significant for hypertension, which was first diagnosed 25 years ago. He smokes half a pack of cigarettes per day and has done so for the past 45 years. Both his father and two of his brothers died from heart disease. There is no other significant family history.

P.E. Findings General: 69-year-old male, no acute distress Vitals: BP – 154/92 mmHg PR – 68/minute Temp – 98.2F RR – 16/minute Neck: No JVP noted No hepatojugular reflux noted No carotid bruits appreciated Cardiovascular system: Precordium normal shape and size No abnormal pulsations appreciated No tenderness to palpation No thrills or heaves S1, S2 heard, no murmurs Respiratory system Clear breath sounds on all lung fields

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