04: Acute Coronary Syndrome: Case 2 Joan
Joan is a 42 year old Lawyer who lives in the west end of Glasgow with her partner Mark. She has been busy with a major court case working long days and weekends. Mark has been worried about Joans stress levels and arranges a surprise week at a cottage in the Highlands to help Joan unwind following the conclusion of the case. Mark has requested non smoking accommodation as neither of them smoke He has brought all of Joans favourite healthy foods and a few of her favourite wines. Joan is careful about her diet as she has risk factors for cardiovascular disease with her father having a myocardial infarction aged 55 and her mother suffering from high cholesterol and high blood pressure. Mark is aware that Joan has not been eating very well over the last few months and is looking forward to the break and spending some quality time together.
After a long journey they both decide on an early night. Joan is wakened at 5am by a crushing pain in the centre of her chest. She has never experienced anything like it before, and feels short of breath and nauseated. She does not want to alarm Mark but after 2 hours she wakens him as she is no better and starting to feel very frightened. Mark notices that Joan is clammy to touch and is concerned, he wants to ring for an ambulance but Joan refuses as she does not want any fuss. Mark finds an information pack in the cottage with details of the local community hospital and Mark drives her there. Joan vomits on her arrival at the hospital.