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DD
History
Important Qs
History
Character of pain, referral, ppt factor
Examination
Epigastric tenderness
Investigations
Investigations
ECG, cardiac enzymes, CBC
DD
History
Important Qs
History
Hypertensive for 30 years on ACEi with regular Fup and
controlled
Diabetic for 30 years on oral antidiabetic with regular
Fup and controlled
ISHD with previous catheter after MI 9stopped heavy
smoking) on aspocid 75mg, anti-ischemic medication
CLD, Hep C +, compensated
Left shoulder pain in left side of the neck and
shoulder , vague character, not referred, precipitated
by carrying his grocery bags, cant associate a
relieving factor.
Examination
Important signs?
Examination
Shoulder examination: free
Neurological examination: hyperthesia left arm
with dermatomal distribution, glove and stock
hypothesia.