Problem:
An established patient came to the office complaining of sudden onset chest pain, nausea, and jaw pain. Per the patient, the pain is sharp and continuous in the chest but dull in the jaw. She woke up with it this morning and it has gotten progressively worse. She was not doing anything out of the ordinary this morning. She is currently under my care for HTN maintenance. Today her vitals are BP: 140/90, Temp: 99.3, Pulse: 120. An EKG was performed and interpreted. I ordered blood work to include cardiac enzymes. I reviewed her medical history and provided a brief exam to include heart and lungs. The pain is midsternal. Her family history is positive for heart disease. The patient is a long-time smoker. Because of her history and her current obesity and high blood pressure she was admitted to observation. I plan on having a Holter monitor places, IV fluids, and nitroglycerin. I will arrange a cardiac consult. The patient was discharged the following day. Myocardial infarction was ruled out.