Ed Eton

55 year old builder

 

PC:      chest tightness

HPC:    lifting bricks this morning

            sudden onset of chest tightness

            tingling in jaw and left shoulder

            SOB at rest during attack

            nausea and sweating

            tightness lasted 1h

            no  previous episodes

PMH:   Basal cell carcinoma at left forehead 1995

            Rheumatoid fever + arthritis in 1960s after sore throat (had “heart                problems” then)

            Road traffic accident 1990 (multiple fractures, ICU admission,                        MRSA sepsis)

            IVDU 40 years ago

DHx:    vitamin pills bd

            St Johns Wart and Cod oil pills

            Viagra prn (prn: pro re nata; when required)

            had Tetracyclin recently for LRTI (lower respiratory tract infection)

            Penicillin allergy

FHx:     father: hyperlipidaemia

            brother: hypercholesterolaemia

            mother: cerebrovascular accident with left hemiparesis and                           dysarthria

            grandfather: DM

SHx:    lives with wife (married for 25 years) and 4 children

            3 units alcohol/week

            smokes 5 cigarettes / day

           chews tobacco