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