A 65-year-old male presents to the emergency department with a three-hour history of progressively worsening central chest pain. The pain radiates down his left arm and into his jaw. He rates it ten out of ten in severity and is associated with nausea. On examination, he is tachycardic, obviously diaphoretic and has a blood pressure of 145/85mmHg. He is a current smoker and works as a taxi driver.
(i) State the most likely diagnosis in this case and list five other potential differential diagnoses.
(ii) Outline the investigations that should be performed as part of the evaluation of a patient presenting with chest pain. Provide a rationale for EACH investigation.
(iii) Explain the steps involved in the acute management of the patients’ presentation. As part of your answer, you should include TWO medications which will be continued on discharge (including mechanism of action and side effects).
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