Hocuspocus
Jun 9, 20201 min
HISTORY
86 yo F h/o HTN, HLD, recurrent UTI who presents to the hospital with one day of left sided chest pain radiating to her left arm. She was in her normal state of health until yesterday when the chest pain began. She is very active and walks 2 miles a day, and has not had chest pain with exertion. She lives with her husband who was recently diagnosed Stage IV lung cancer.
No nausea, vomiting, headache, blurry vision or shortness of breath.
VITALS
T 97 HR 93 BP 137/77 RR 13 SpO2 98% on room air
EXAM
AOx3, thin, appears younger than age, mild distress due to chest discomfort
No lymphadenopathy, no prominent jvd
S1, S2, 2/6 systolic murmur
Lungs clear
Abdomen soft, nontender
no lower extremity edema
POCUS cardiac exam
Parasternal Long View
Parasternal Short View
Apical 4 chamber view
LABS
WBC 6, Hgb 11, Plt 240k
BUN 19 Cr 1.0
Troponin 1.5 --> 3
BNP 350
EKG
She was taken to the cath lab which showed mild, non-obstructive coronary artery disease.
What is the diagnosis?