Cardiology Case Challenge: Worsening Chest Pain After a Respiratory Infection in a Man With Hypertension

Abhimanyu Beri, MD; Fadi Abu-Yasin, MD


March 24, 2022

Editor's Note:
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A 60-year-old man with a history of diabetes mellitus and hypertension presents with a 1-day history of retrosternal chest pain. The chest pain began while he had been resting and continued to worsen over the next few hours. He describes it as a sharp pain that is moderate in intensity, with radiation to his right shoulder and neck. The pain worsens when he is lying down and with deep breathing, but it is relieved by bending forward. He denies having shortness of breath or palpitations.

The patient has a medical history of hypertension, diabetes, hypercholesterolemia, and adenocarcinoma of the prostate. In addition, the day before the symptoms occurred, he was diagnosed with costochondritis during a visit to his family doctor.

Review of his systems is significant only for a recent respiratory infection that had improved approximately 2 weeks before presentation. His medications include enalapril, hydrochlorothiazide, metformin, and a statin. He has smoked one pack of cigarettes a day for the past 20 years. The patient's family history is significant for premature coronary artery disease in two of his brothers.


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