[Solved]: : This is a 53-year-old female who presents here…

: This is a 53-year-old female who presents here with chest pain. She states that it started about two hours ago. She had pain which started in the chest and now has gone to the left arm. This has been more of a persistent pain that she has had recently. She does occasionally have chest pain and does have nitroglycerin. She has taken two nitroglycerin and has not had relief. The patient does not have any significant shortness of breath associated with this chest pain and tightness and has had no diaphoresis. No nausea or vomiting. No history of trauma. The patient states that three years ago in Las Vegas she had bypass surgery. She sees Dr. Bernard, known for having a cardiac evaluation by him last fall, and was told that she had a heart murmur and a valve problem, but that it was not getting worse and did not require treatment. ALLERGIES: The patient has no known drug allergies. PAST MEDICAL HISTORY : She does have a history of hypertension, hyperlipidemia, mild obstructive airway disease, is postmenopausal and has mild degenerative joint disease with chronic lower back pain. MEDICATIONS: She is on Atenolol 25 mg q.d., multivitamin, vitamin E 400 international units q.d. Lipitor 20 mg q.d. hydrocodone 1 q.h.s., triamterene HCTZ and Paxil 10 mg 1/2 tablet q.d. SOCIAL HISTORY: The patient is married; she is not wo