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Life Threatening? No
Write-up: 64-year-old female with history of angina nitrates presents from vaccine clinic with chest pain slightly different than her classic chest pain. Also has history of fibromyalgia and chronic neck pain. Initial complaint was of epigastric discomfort and burning however given her history EKG obtained initial enzymes. EKG with some flipped T waves that have flipped back and forth in prior EKGs as well. She had a negative troponin. During her stay she had that pain resolved and that her chronic pain returned, this improved as well with nitro and morphine, EKG did not change on repeat and repeat troponin continued to be negative. Given patient''s history she is already on significant risk factor modification, is requesting to be discharged and I believe that close follow-up with her cardiologist is a reasonable plan given serial negative troponins. Low suspicion for PE dissection or other acute pathology. X-ray unremarkable.
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