Intended for healthcare professionals

Endgames Case Review

Chest pain with a cold

BMJ 2020; 371 doi: (Published 05 November 2020) Cite this as: BMJ 2020;371:m3742
  1. Andrew J Morrow, clinical research fellow1 2,
  2. Thomas J Ford, British Heart Foundation clinical research fellow1 2 3 4,
  3. Margaret McEntegart, consultant cardiologist1 2
  1. 1West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK
  2. 2British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
  3. 3Faculty of Medicine, University of Newcastle, Callaghan, Australia
  4. 4Department of Cardiology, Gosford Hospital, Central CoastLocal Health District, Gosford, Australia
  1. Correspondence to M McEntegart, margaret.mcentegart{at}

A man in his 60s presented to the emergency department with two hours of gradually worsening right-sided chest pain that occurred at rest.

During the week before presentation he had also experienced a coryzal illness, including rhinorrhoea, non-productive cough, fever, and lethargy.

He described shorter episodes of chest pain, lasting less than 15 minutes, for four weeks before this attendance, but he had not sought medical advice.

His vital signs were stable, he was apyrexial, and had normal heart sounds and no pericardial rub. His right chest wall was tender to palpation, particularly at the costochondral margins.

The patient was a smoker, had a history of hypertension and dyslipidaemia, and a family history of angina. …

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