Emergency Cardiac Care Simulation: From Initial
Chest Pain Presentation Through Cardiac
Catheterization Planning - A Complete
Myocardial Infarction Management Scenario
Simucase content but follows similar clinical judgment principles.
🧾 CASE BACKGROUND & PATIENT INFORMATION
Patient Profile:
text
NAME: Robert Chen
AGE: 65 years
GENDER: Male
MRN: 123456
ROOM: 510-A
ADMISSION DATE: Today
ADMITTING DIAGNOSIS: Chest pain, rule out acute coronary syndrome
Medical History:
text
PRIMARY DIAGNOSES:
• Hypertension (Diagnosed 2005)
• Hyperlipidemia (Diagnosed 2010)
• Type 2 Diabetes (Diagnosed 2015)
• Obesity (BMI 32.5)
SURGICAL HISTORY:
• Cholecystectomy (2000)
• Right inguinal hernia repair (2015)
,ALLERGIES:
• Codeine (Nausea and vomiting)
• No known food allergies
IMMUNIZATIONS:
• Influenza: 11/2024
• Pneumococcal: 04/2023
• COVID-19: Booster 02/2024
Current Medications (Home):
text
1. Lisinopril: 20 mg daily
2. Atorvastatin: 40 mg at bedtime
3. Metformin: 1000 mg BID
4. Aspirin: 81 mg daily
5. Metoprolol: 50 mg BID
Social History:
text
OCCUPATION: Retired accountant
TOBACCO: Former smoker, quit 2010 (20 pack-year history)
ALCOHOL: 1 glass of wine with dinner occasionally
SUBSTANCE USE: Denies illicit drug use
LIVING SITUATION: Lives with wife in two-story home
DIET: Low sodium, low fat per cardiology recommendations
ACTIVITY: Walks 30 minutes daily, but has been less active recently due to fatigue
SUPPORT SYSTEM: Wife (very supportive), two adult children live out of state
📋 INITIAL ASSESSMENT DATA
Vital Signs (Room 510-A at 14:00):
text
• Temperature: 37.0°C (98.6°F) oral
• Heart Rate: 98 bpm (regular)
• Respiratory Rate: 22 rpm
• Blood Pressure: 158/92 mmHg
• Oxygen Saturation: 96% on room air
, • Pain: 7/10 (substernal chest pressure)
• Height: 180 cm (5'11")
• Weight: 95 kg (209 lbs)
• BMI: 32.5
Chief Complaint (Patient's Words):
"I was watching TV and suddenly felt this crushing pressure in my chest. It's been going on for about
an hour now."
History of Present Illness (HPI):
text
TIMELINE:
• 1 hour PTA: Sudden onset of substernal chest pressure while at rest watching TV
• 45 minutes PTA: Chest pressure intensified, rated 7/10, accompanied by shortness of
breath and diaphoresis
• 30 minutes PTA: Wife called 911, paramedics arrived and administered 324 mg aspirin
and sublingual nitroglycerin x1 with partial relief (pain decreased to 5/10)
• Now: Chest pressure persists, radiates to left arm and jaw
SYMPTOM PROFILE:
• Chest pain: Pressure, 7/10, substernal, radiates to left arm and jaw
• Dyspnea: Present at rest
• Diaphoresis: Profuse sweating
• Nausea: Reports feeling nauseated
• Lightheadedness: Denies
• Palpitations: Denies
PARAMEDIC REPORT:
• Initial ECG in field: ST elevation in leads II, III, aVF
• Given aspirin 324 mg and nitroglycerin 0.4 mg sublingual x1
• IV established: Normal saline at 50 mL/hr
🔍 COMPREHENSIVE REVIEW OF SYSTEMS
Cardiovascular:
text
• Chest pain: Pressure, substernal, radiating to left arm and jaw
Chest Pain Presentation Through Cardiac
Catheterization Planning - A Complete
Myocardial Infarction Management Scenario
Simucase content but follows similar clinical judgment principles.
🧾 CASE BACKGROUND & PATIENT INFORMATION
Patient Profile:
text
NAME: Robert Chen
AGE: 65 years
GENDER: Male
MRN: 123456
ROOM: 510-A
ADMISSION DATE: Today
ADMITTING DIAGNOSIS: Chest pain, rule out acute coronary syndrome
Medical History:
text
PRIMARY DIAGNOSES:
• Hypertension (Diagnosed 2005)
• Hyperlipidemia (Diagnosed 2010)
• Type 2 Diabetes (Diagnosed 2015)
• Obesity (BMI 32.5)
SURGICAL HISTORY:
• Cholecystectomy (2000)
• Right inguinal hernia repair (2015)
,ALLERGIES:
• Codeine (Nausea and vomiting)
• No known food allergies
IMMUNIZATIONS:
• Influenza: 11/2024
• Pneumococcal: 04/2023
• COVID-19: Booster 02/2024
Current Medications (Home):
text
1. Lisinopril: 20 mg daily
2. Atorvastatin: 40 mg at bedtime
3. Metformin: 1000 mg BID
4. Aspirin: 81 mg daily
5. Metoprolol: 50 mg BID
Social History:
text
OCCUPATION: Retired accountant
TOBACCO: Former smoker, quit 2010 (20 pack-year history)
ALCOHOL: 1 glass of wine with dinner occasionally
SUBSTANCE USE: Denies illicit drug use
LIVING SITUATION: Lives with wife in two-story home
DIET: Low sodium, low fat per cardiology recommendations
ACTIVITY: Walks 30 minutes daily, but has been less active recently due to fatigue
SUPPORT SYSTEM: Wife (very supportive), two adult children live out of state
📋 INITIAL ASSESSMENT DATA
Vital Signs (Room 510-A at 14:00):
text
• Temperature: 37.0°C (98.6°F) oral
• Heart Rate: 98 bpm (regular)
• Respiratory Rate: 22 rpm
• Blood Pressure: 158/92 mmHg
• Oxygen Saturation: 96% on room air
, • Pain: 7/10 (substernal chest pressure)
• Height: 180 cm (5'11")
• Weight: 95 kg (209 lbs)
• BMI: 32.5
Chief Complaint (Patient's Words):
"I was watching TV and suddenly felt this crushing pressure in my chest. It's been going on for about
an hour now."
History of Present Illness (HPI):
text
TIMELINE:
• 1 hour PTA: Sudden onset of substernal chest pressure while at rest watching TV
• 45 minutes PTA: Chest pressure intensified, rated 7/10, accompanied by shortness of
breath and diaphoresis
• 30 minutes PTA: Wife called 911, paramedics arrived and administered 324 mg aspirin
and sublingual nitroglycerin x1 with partial relief (pain decreased to 5/10)
• Now: Chest pressure persists, radiates to left arm and jaw
SYMPTOM PROFILE:
• Chest pain: Pressure, 7/10, substernal, radiates to left arm and jaw
• Dyspnea: Present at rest
• Diaphoresis: Profuse sweating
• Nausea: Reports feeling nauseated
• Lightheadedness: Denies
• Palpitations: Denies
PARAMEDIC REPORT:
• Initial ECG in field: ST elevation in leads II, III, aVF
• Given aspirin 324 mg and nitroglycerin 0.4 mg sublingual x1
• IV established: Normal saline at 50 mL/hr
🔍 COMPREHENSIVE REVIEW OF SYSTEMS
Cardiovascular:
text
• Chest pain: Pressure, substernal, radiating to left arm and jaw
