23rd July 2020

You are an F2 working in the Emergency Department. A 64-year-old man is driven in by his wife as he had some central chest pain

You are an F2 working in the Emergency Department. A 64-year-old man is driven in by his wife as he had some central chest pain while picking flowers in his garden that afternoon. His wife has angina, and he had a spray of her GTN before sitting down on a bench in the garden, following which the pain settled after around half an hour. He is a smoker of 30 pack years and has type II diabetes mellitus. His father died of a heart attack at 59. An ECG done by the paramedics shows normal sinus rhythm. He has some further central chest pain whilst in the waiting room, and a repeat ECG is also normal – but the pain has settled by time of assessment.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.