Case synopsis

A 74-year-old woman enters your hospital, which has no cardiac catheterization or revascularization facilities, and the nearest centre is a 90 minute transfer. She has the following complaints/characteristics:

• 11 hours waxing and waning central chest pressure
• Nausea and vomiting x 3
• Prior history of hypertension treated with diuretic
• Prior history of untreated hyperlipidaemia
• Prior history of gastritis
• Prior history of smoking (quit > 50 years ago)