Journal Logo

Cases in Electrocardiography

Symptoms: Elderly Woman with Chest ‘Muscle Tightness’

Chan, Theodore MD; Brady, William MD; Harrigan, Richard MD

Author Information

    A 76-year-old woman with a history of hypertension presented to the emergency department with one day of chest pain. The pain started when she woke that morning, and was not related to exertion. She described the pain as a “muscle tightness,” 3/10 in severity, constant in nature, and exacerbated by deep inspiration with some subjective shortness of breath.

    Figure
    Figure

    She denied pain radiation, nausea, diaphoresis, palpitations, or lightheadedness. Her only cardiac risk factors were hypertension and a distant history of smoking. On exam, her pulse rate was 86 beats per minute, blood pressure 133/54 mm Hg, respiratory rate of 18 breaths per minute, and a temperature of 97.2°F. On ausculatation, her chest was clear bilaterally, and her heart revealed a regular rate with normal S1 and S2, and no murmurs, rubs or gallops. An electrocardiogram was obtained with the computer interpretation of “ACUTE MI” pattern (Figure 1).

    What is this patient's diagnosis?

    Figure
    Figure
    © 2004 Lippincott Williams & Wilkins, Inc.