Acute myocardial infarction due to coronary artery atherosclerosis with thrombus
AI-generated summary
A 49-year-old man with significant cardiac risk factors (smoking, hypertension, diabetes, hypercholesterolaemia, family history) presented to his GP with retrosternal chest pain two days before death. The GP diagnosed indigestion based on symptom relief with antacids and prescribed acid reflux medication. No electrocardiogram or cardiac markers were obtained. The patient died of acute myocardial infarction from a coronary thrombus that histologically was approximately one week old, meaning it developed before or around the time of the GP consultation. Expert reviews found the diagnosis was reasonable given the patient's presentation and symptom relief with antacids, but noted the patient minimised symptoms and was not entirely frank about their severity. The coroner emphasised the importance of documenting vital signs and clear management plans, and highlighted the role of patient candour in clinical assessment.
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