Hello I have a question


a 68 year old comes to er with 1 hour history of sharp substernal chest pain. There is no radiation of the pain. He is also somewhat short of breath but is not diaphoretic or nauseated. The pain occured from physical activity. There have been no prior episods of pain and has general good health. He is a nonsmoker whose father died at 67 of "heart trouble." he has no allergies, and his madications are vitamines and ranitidine for indigestion over the last 2 months.

Vital signs are: temp 37.4c (99.3f), blood pressure 130/80 mm hg, and raspirations 22/min. Head eyes ears and throat examination is normal. His chest is clear bilaterally and the pain is not reprodued by palpation. Cardiovascular exam showed tachycardia with no murmurs or gallops. His liver is enlarged, and his extremities are not edematous.

1) what could be the 5 disease states in your diagnosis
2)what is the initial diagnostic plan for this patient?


Thank you very much,