Author: Diana George / Editor: Nick Tilbury / Codes: CC1, CC2, CP1, CP3, CP4, SLO1 / Published: 01/02/2022

A 44-year-old gentleman presents to the Emergency Department following a sudden loss of consciousness lasting for approximately 3 minutes. Immediately prior to this he had experienced palpitations and profuse sweating. He currently complains of a persistent tight, left-sided chest pain radiating to both arms, which has been intermittent for the last 2 days but persistent in the last few hours.

He initially ignored the pain as he thought it might be indigestion as he frequently gets the same feeling when he overeats.

His past medical history includes poorly controlled type-two diabetes mellitus.

His initial observations in the resuscitation room are:

  • Heart rate – 76 beats per minute
  • Blood pressure – 110/80mmHg
  • Respiratory rate – 20 per minute
  • SpO2- 99% on air
  • Temperature – 37°C
  • Capillary blood sugar – 24 mmol/L An ECG is performed and shown below.