You think this is a cardiac problem?

They say a little knowledge is a dangerous thing.  So, having lots of knowledge can only make things worse I guess.

We were called out to a 27 year old man complaining of chest pain.  Now, unless there are underlying congenital or genetic causes you can prepare yourself to dismiss these cases as anything else other than a heart attack.

On our arrival the front door was ajar so, I pushed it slowly open to reveal a narrow corridor leading to the living room ahead.

I could hear talking and knew an FRU was already on scene with our patient.  Switching to OSCE mode (Objective Structured Clinical Examination) from our training school, I stepped in and theatrically swung my arms out.

“I AM ASSESSING FOR DANGER . . . IS IT SAFE TO APPROACH THE PATIENT?”

From round the corner in the living room came the FRU’s response.

“THERE IS NO DANGER . . . IT IS SAFE TO APPROACH THE PATIENT”

Upon entering we were presented with a young man sitting quietly on his sofa.  He had perfect muscles, a perfect tan, perfect skin, perfect stubble . . . and perfect features.  And the lights set strategically in the corner of his room offered up the best ambiance to show off the tone of his chest and biceps.

The hand over from the FRU went loosely as follows . . . he had been suffering pain in the right side of his chest for two days – worsening when he leant forward.  The pain had cleared up but then had come back again last night.  He had no medical history and no family history of heart problems either.  He didn’t smoke or drink alcohol, went to the gym regularly and did a lot of running.  Oh, and he had just come over from Egypt as a newly qualified Doctor.

“Egypt eh . . . that would explain those amazing looks.  And you’re a Doctor yes?”  I asked raising my eyebrows.
“Yes.”
“. . . . . . is that like a real Doctor?  Or a Doctor like Dr Pepper is a Doctor?”

He smiled, allowing my subtle attempt at sarcasm brush over him.

“A real Doctor.  I qualified this year after taking my exams here in London.”
“Wow.  So, seeing as you’re a Doctor, what do you think this is?”
“Cardiac problem”
“Wh-wha . . . um . . . cardiac?!”
“Yes.  Cardiac”
“You think this is a cardiac problem?”
“Yes.”
“You.”
“Yes.”
“At your age.”
“Yes.”
“With that body.”
“Yes.”
“And your history.”
“Yes.”
“And those looks.”
“Yes.”
“Cardiac.”
“Yes.”
“You.”
“Yes.”
“A Doctor.”
“YES.”
“Ri-i-ight . . . . . . ”

I glanced over at Marvin.  His eyes had long ago glazed over and he seemed lost in a fantastical world of techno music within his head.  I looked over at the FRU – she smiled benignly, giving an ever so slight suggestive hint that she might prefer dipping her head in a bucket of bullet ants than continue working on this job.

I scratched my chin thoughtfully.

“Cardiac right.”
“Y-”  I cut him off with a pert smile.
“I don’t think so eh . . . Joey, ECG please”

Rather unsurprisingly, the ECG showed the most normal sinus rhythm an ECG could ever show – ever.  His observations also remained within the realms of super human perfect and eventually, with all the evidence laid out before him, he finally started believing this might not actually be a cardiac problem . . . and more likely a muscular skeletal one instead.

“Want to go to hospital?”  I suggested.
“I . . . I think not.  I think I’ll just take some paracetamol and see how it goes.”
“And might I just say sir, an excellent choice”  I bowed slightly.

He was eventually left at home with his partner and referred to a GP.  Sitting back in the Ambulance we all took a deep sigh and chuckled to ourselves.  Joey summed it up appropriately . . .

“Well, that’s another life saved eh”

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