Abstract
A 57-year-old white male presented to the emergency room with substernal chest pressure/tightness, left forearm pain, and dyspnea at rest. Two weeks prior, the patient had noted an increase in fatigue. He had a past medical history of peptic ulcer disease, hypertension, and hypercholesterolemia. Medications included enalapril for hypertension, atorvastatin for hypercholesterolemia, and omeprazole for peptic ulcer disease. The social history was significant for smoking a pack of cigarettes a day for 30 years (30 pack-years). On examination, a systolic murmur and 2+ pitting edema were appreciated. Chest X-ray revealed diffuse infiltrates and an electrocardiogram exhibited 7 mm ST elevation in the anterior leads. Laboratory results were significant for a mildly elevated white blood cell count, creatine kinase of 541 U/L (normal 70–185 U/L), CK-MB of 78.4 ng/mL (normal <6.0 ng/mL), and troponin I of 4.53 ng/mL (normal <0.034 ng/mL), consistent with myocardial infarction.
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Muldrew, K.L., Weck, K.E. (2011). Pharmacogenetics. In: Schrijver, I. (eds) Diagnostic Molecular Pathology in Practice. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-19677-5_10
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