A 74-yr-old man comes to the Emergency Department (ED) because of a several-month history of increasing exertional chest pain. He states that after walking a few feet he feels left-sided chest pressure that radiates down his left arm. Lately, the pain has been associated with dyspnea and nausea. The pain is relieved by rest within a few minutes. He saw his primary care physician a few days ago. At that time, he was given a prescription for sublingual nitroglycerin as a therapeutic trial and was scheduled for an outpatient stress test in a few weeks. He comes to the ED today because the episodes have been occurring more frequently and with less exertion. He says today that when he takes the sublingual nitroglycerin, it does relieve his symptoms.
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