Case Study - CL

Last week, I saw a pleasant, but rather anxious, 73yrs old Chinese Lady. She presented with a history of aches all over the body, as well as chest pains. The chest pains were not like that of angina pectoris. She had coronary risk factors of hypertension. She is a known asthmatic and had taken a slight overdose of seretide, in her panic over the chest pains, and general unwellness. When I saw her, she had a BP of 80 mmHg systolic, HR 110/min SR and normal precordial examinations. Her lungs were clear. The resting ECG was within normal limits apart from sinus tachycardia. There were no signs of thyrotoxicosis. Initial blood test showed no evidence of acute myocardial infarction. The CXR was essentially normal.

1. What is your differential diagnosis?
2. How will you manage this patient?
3. What other investigations would you request?