The other day I had a 43 year old man come in via EMS because he has syncopised (passed out) in the golf pro shop after finished a round. He had been having some vague shoulder and neck pain for about a day on and off but was able to shoot a 77 despite almost falling over on the 18th green. His golfing buddies accompanied him in and a little while later his wife showed up. His EKG was worrisome. Although he did not meet STEMI (acute heart attack) criteria, he had ST depression and some other abnormalities. I called the interventional cardiologist in because I figured he would want to take him to the cath lab (for an angiogram). This guy was sort of your typical guy, brushing off symptoms and the fact that he smoked – his wife was giving him grief for it. The cardiologist asked him what kind of work he did – and he responded “sales”. To which his wife sarcastically retorted, “not much!”. The patient then looked sternly at his wife and said, “oh, I’m sorry, do you do much? – Oh yeah, I forgot, YOU DON’T HAVE A JOB!”. Whoa! One of the friends of the guy leaned over to me and asked “Hey Doc, can we get a marriage counsellor consult down here?”. Ummm… awkward moment…..
He wound up going to the cath lab where he got two stents for his 99% occlusion of his RCA (right coronary artery).