ECG performed on admission shows sinus rhythm and deep ST depression in leads II, III and a VE
Serial cardiac enzymes Repeat ECG in 4 hours Chest X-ray Full blood count
Oxygen and cardiac monitor Aspirin (already given) Nitrate infusion Enoxaparin
Diltiazem (beta-blocker contraindicated owing to COPD) Advice to stop smoking
1. review anti-anginal management
2. referral for mammography and fine needle aspiration of breast lump
3. spirometry and assessment of inhaler technique.
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