Question

A 58-year-old man is found unresponsive by his wife. According to his wife, he was complaining of a "dull ache" in his chest the day before, but refused to allow her to call 911. His blood pressure is 70/50 mm Hg, his pulse is 120 beats/min and weak, and his respirations are 28 breaths/min and labored. Further assessment reveals that his skin is cool, pale, and clammy. You should suspect:

a) Cardiac tamponade
b) Aortic dissection
c) Acute myocardial infarction
d) Tension pneumothora

Answer 1

The presentation of chest pain, low blood pressure, rapid pulse, and labored respirations in a 58-year-old man is indicative of an acute myocardial infarction, which calls for immediate medical care.

Step-by-step explanation:

The clinical presentation you’ve described suggests that the 58-year-old man likely has an acute myocardial infarction (AMI). The symptoms of a “dull ache” in the chest the day before, along with the current findings of low blood pressure (70/50 mm Hg), tachycardia (a pulse of 120 beats/min and weak), tachypnea (28 breaths/min and labored respirations), cool, pale, and clammy skin are characteristic of AMI. Additionally, since many symptoms like difficulty breathing, chest pain, and changes in skin temperature and color can overlap with other conditions, a differential diagnosis is critical.

It is essential not to dismiss chest pain and symptoms that could signify a heart problem, especially in an older adult. The fact that the wife reports that he refused medical care the previous day further underscores the importance of prompt medical evaluation when experiencing potential cardiac symptoms. Acute myocardial infarction is a life-threatening condition requiring immediate medical attention.