Mrs Brown (54 years) is brought to the emergency department by her husband following two episodes of chest pain

Mrs Brown (54 years) is brought to the emergency department by her husband following two episodes of chest pain

Mrs Brown (54 years) is brought to the emergency department by her husband following two episodes of chest pain, lasting approximately 15 minutes each, at work. She reports she has had increasing frequency of angina in the last few weeks. She does however admit to not taking her medication as required as she believed she had recovered from angina. Mrs Brown is admitted to hospital, to the medical ward, six hours later for further investigation. Her husband and family accompany her. She has a history of hypertension, her weight is 120kg, and she currently has an executive management job. Observations on admission are temperature 37.2oC, pulse 110b/min, respirations 24 respirations/min, and BP 146/89mmHg. You are working as a new graduate registered nurse on this ward. When you introduce yourself to Mrs Brown she tells you how stressed she is in her current job with numerous projects to develop and manage and tells you “I have no time to exercise anymore and I?m so busy and so tired my husband and I just end up eating take away a few times a week as I can?t be bothered cooking.” Later that evening you answer Mrs Brown?s nurse call bell and she tells you she has chest pain now. She states she just went for a walk around the ward and started to feel a bit short of breath. She rubs her sternum and left upper arm. She states her pain score is 9 out of 10. When you ask her to describe her pain she states “It feels like someone?s squeezing or pressing down on my chest, it feels really tight.” She has an anxious look on her face, is pale and you can see her face is a little sweaty

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