Case scenario: 55 year old man admitted to the unit with acute coronary syndrome. Tells me that he came into the hospital because of an episode of chest pain that he developed while out for a walk.  He described his pain as a pressure sensation rated 7/10. Pain was retrosternal, nonradiating and subsided after talking 2 sprays of nitro. Pain was accompanied by nausea and diaphoresis. He states that he has been having recurring chest pain over the past week when walking. He is pain free at present. His breathing is unlaboured, resp are quiet, chest is clear, skin warm to touch, colour is pink, BP 142/88, Sao2 99% on 3L by nasal prong, weight 116.5kg. He is on numerous meds for high B/P, diuretics, blood thinners, hes diabetic type 2. His EKG had normal sinus rhythm....CK levels 243U/L and troponin at 0800 where <0.02 ng/mL and at 1630 troponin 0.08 ng/mL.......would you say this patient has had an MI?
Not an MI but stable angina he needs angiogram to see the extent of narrowing of coronary vessels and also go for 2D ECHO to see the ventricular function