- Obs including BP in both arms if possible?
- Can you do an ECG now, before I arrive?
- What was he admitted with? Any cardiac history, recent surgery or immobility?
Do now
- ECG within 10 minutes — compare with old
- See them: A–E, history of the pain
- Troponin and bloods
- Treat ACS / think of PE and dissection
Key doses
- Aspirin 300 mg if ACS suspected (not if dissection likely)
- GTN 400 micrograms SL if SBP > 90
- Oxygen only if SpO₂ < 94%
Typical adult doses — always check the BNF and your local guideline.
Call your senior if
- ST elevation — STEMI pathway now
- Ongoing pain, haemodynamic instability
- Suspected dissection or massive PE
Think of
- ACS
- PE
- Aortic dissection
- Pneumothorax
- Pericarditis
- GORD / musculoskeletal (diagnosis of exclusion)
Go deeper
The full walkthroughs behind this call.