Acute coronary syndrome — recognition
Typical: crushing retrosternal pain, radiating to the jaw, neck or left arm, with diaphoresis, nausea, dyspnea, anxiety. Atypical, common in women, older adults and people with diabetes: unusual fatigue, dyspnea on exertion, epigastric heaviness, nausea, clammy grey skin, without any chest pain. Absence of chest pain does not rule out infarction. Priorities: 12-lead ECG within 10 minutes, cardiac monitor, oxygen only if the saturation is low, IV access, ASA, nitroglycerin after checking blood pressure and PDE-5 inhibitors, troponin.