Author Affiliations
Case Presentation
A 69-year-old female presents to the emergency room (ER) with a 20-day history of left-sided sharp chest pain radiating to the left shoulder associated with worsening exertional dyspnea. She has non-oxygen dependent chronic obstructive pulmonary disease (COPD), limiting her activities of daily living (ADL), hypercholesterolemia, essential hypertension stage 1, coronary artery disease requiring left anterior descending artery (LAD) stenting, and non-insulin dependent diabetes mellitus type 2. Her blood glucose and blood pressure are well controlled, she is compliant with her medications, which include losartan, hydrochlorothiazide, atorvastatin, aspirin, metformin, glipizide, fluticasone, albuterol metered dose inhaler (MDI), and ipratropium MDI. On the physical exam, the patient is in mild respiratory distress, afebrile with the following vitals (Table 1):
| Blood pressure | Heart rate | Respiratory rate |
|---|---|---|
| 136/84 mm Hg | 87 bpm | 21/min |
Table 1: Vital measurements
Question
Pearl
Coronary artery disease (CAD) is the leading cause of death in both men and women in the United States. CAD causes significant morbidity and mortality. Accurate evaluation is important to facilitate appropriate diagnosis and treatment. Ordering the appropriate test for each patient will reduce unnecessary testing and waste. The ubiquitous nature of CAD requires all practitioners, regardless of their specialty, to be familiar with invasive and noninvasive diagnostic modalities for diagnosis and risk stratification.
Educational Resources
Acknowledgment
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Funding
None
Author Information
Multiple Teams
TeamHealth Communications, USA
Informed Consent
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COI Statement
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Guarantor
None
DOI
Cite this Article
Multiple Teams. Clinical Pearl: Workup of Left-Sided Chest Pain in a COPD Patient. medtigo J Med. 2024;2(4):e30622437. doi:10.63096/medtigo30622437 Crossref
