Ischaemic heart disease

A 54-year-old man presents to a metropolitan hospital with a catheter laboratory after seventy minutes of central chest pain, which is continuing. His blood pre…

Pre-internship · middle twist

A 66-year-old man has had ninety minutes of central chest pain with sweating. His electrocardiogram shows 3 mm ST elevation in leads II, III and aVF with ST dep…

Pre-internship · niche

A 63-year-old man with two hours of chest pain has 3 mm of ST elevation in leads II, III and aVF. He is alert but cold and clammy. Pulse is 52 beats per minute…

Pre-internship · middle twist

A 58-year-old man has had constant central chest heaviness for 70 minutes, radiating to his left arm, with sweating and nausea. The pain is unchanged by posture…

Clinical rotations · middle twist

A 64-year-old man is recovering in hospital four days after an inferior ST-elevation myocardial infarction treated with primary percutaneous coronary interventi…

Clinical rotations · middle twist

A 62-year-old woman is reviewed three months after a large anterior myocardial infarction. She has mild exertional breathlessness but no recurrent chest pain; t…

Clinical rotations · common

A 78-year-old man presents with an anterior ST-elevation myocardial infarction at a hospital where primary percutaneous coronary intervention cannot be delivere…

Clinical rotations · middle twist

A 64-year-old man becomes hypotensive shortly after reperfusion of an inferior ST-elevation myocardial infarction. He is distressed but has clear breath sounds,…

Clinical rotations · common

A 59-year-old man presents 90 minutes after onset of severe central chest pain with sweating and nausea. The ECG shows 3 mm ST-segment elevation in leads II, II…

Clinical rotations · middle twist