Chest pain, sitting forward

Instructions

You are a medical student on placement in the emergency department. Tom Halloran, 27, has had two days of sharp central chest pain, worse lying flat and better sitting forward, a week after a cold. T 37.8, HR 96, BP 124/78, SpO2 98%.

1. 1

   Interpret the ECG provided

2. 2

   Outline to the examiner:

   • Your most likely diagnosis and differentials
   • Next steps in management, including relevant investigations

• You do not need to take a history or examine the patient
• The examiner will ask you a question at the end

ECG