ABSTRACT
This chapter presents a case history of a 56-year-old lorry driver who was brought to the emergency department at his local hospital by a paramedic crew. The patient gave a 2-hour history of sudden-onset, central, crushing chest pain, with radiation to his jaw and left arm, which had woken him at 6 am. This case shows how the diagnosis depends on the medical history, markers of myocardial injury, and changes on sequential electrocardiograms (ECGs); and how recent advances in medical therapy have significantly improved morbidity and mortality. Specific ECG leads examine different areas of the heart. Percutaneous coronary intervention or percutaneous transluminal coronary angioplasty is increasingly being used for recanalisation of the occluded coronary artery in acute myocardial infarction (MI). Cardiac rehabilitation provides a safe, controlled programme to improve cardiovascular fitness, promote secondary prevention through diet and lifestyle modification, and reduce the psychological impact of the MI.
