# A 59-year-old black female is admitted at midnight with a diagnosis of Chest Pain. She complains of a squeezing type

###### Question:

A 59-year-old black female is admitted at midnight with a diagnosis of Chest Pain. She complains of a squeezing type pain across her chest and into her left jaw area.

Assessment Findings

Vital signs are Blood Pressure-200/110; Pulse-128 beats per minute; Respirations- 26 per minute; Temperature-99.8; Saturation of Oxygen-86% on room air; pain level 9/10.

During your initial assessment, she is rubbing her mid-chest, grimacing, and is diaphoretic. The pain has been occurring intermittently throughout the evening and night. Her color is pale except around her lips which are bluish. Cardiac auscultation reveals a rapid regular rhythm and a murmur, no pulse deficit.  She has never had this pain before. Lungs sounds are crackles on both bases with clear upper lobes. She is afraid she is going to die.

Per standing orders, a nurse administers & administers Nitroglycerine 0.4mg sublingually; applies cardiac electrodes for continuous cardiac monitoring; obtains an electrocardiogram; places a peripheral intravenous catheter with saline lock; positions patient in low Fowlers. On assessment vital signs are Blood Pressure-180/95; Pulse-108 beats per minute; Respirations- 22 per minute; Temperature-99.0; Saturation of Oxygen-90% on 2 liters per minute; Pain level 8/10. She says her chest pain hasn’t changed. Heart and lung sounds are unchanged. Color is pale without previous blue changes.

What labs would be drawn for this patient that would identify if the pain is from the cardiac origin? What would the results be if the patient is having cardiac damage?

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