Male, 60s, asbestos with "pleural plaques", "Chest tightness" on and
off past 3-6 weeks on hills, no pain, SOB with it. Last episode 3
days ago. BP on arrival 211/130 settling to 202/120 after 5 mins,
digital. Mercury similar 200odds/120odds. Pulse irregular 90bpm or
so, AF like but not quite - odd little runs of tachy. HS OK.
Presenting at emergency appoint, not the brightest star in the galaxy.
Bilat basal creps but not many, no ankle oedema.
What to do?
1. Refer chest pain clinic within (probably) 7 days?
2. Send A&E / Med Reg for assess today?
3. Fax referral to cardiology secretary?
4. Nothing. This is what we pay our defence fees for. :)
Any or all 3(4) of above? I did (2) and med reg subsequently thought
I should have done (1) or (3). We discussed it, but failed to agree.
What would you have done?
--
Paul
Glasgow
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