Clinical Pearl: Workup of Left Sided Chest Pain in a COPD Patient

Case Presentation A 69-year-old female presents to the emergency room (ER) with a 20-day history of left sided sharp chest pain radiating to the left shoulder associated with worsening exertional dyspnea. She has non-oxygen dependent chronic obstructive pulmonary disease (COPD) limiting her activities of daily living (ADLs), hypercholesterolemia, essential hypertension stage 1, coronary artery disease requiring left anterior descending artery (LAD) stenting and non-insulin dependent diabetes mellitus type 2. Her blood glucose and blood pressure are well controlled, she is compliant with her medications which include losartan, hydrochlorothiazide, atorvastatin, aspirin, metformin, glipizide, fluticasone, albuterol metered dose inhaler (MDI) and ipratropium MDI.