Case 1
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Internal Medicine
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A 68-year-old woman is day 6 after a hemicolectomy. She becomes acutely breathless with pleuritic chest pain. Respiratory rate 28, heart rate 118, blood pressure 108/70, saturations 89% on air, chest clear.
A 58-year-old smoker with hypertension has 40 minutes of central crushing chest pain radiating to the left arm, with sweating and nausea. ECG shows 3 mm ST elevation in leads II, III and aVF.
A 63-year-old man with 15 years of type 2 diabetes has a 2 cm ulcer under the first metatarsal head, present for three months. The surrounding skin is callused, the foot is warm with bounding pulses and monofilament sensation is absent.