Abstract
We encountered a patient who suffered angina and whose treatment was difficult. The patient was an 82-year-old man who had vasospastic angina, spasm-related angina, old myocardial infarction, and paroxysmal atrial fibrillation, and was under oral medication for these diseases. An emergency call was made for the patient who complained of acute chest pain. After sublingual nitrate was administered by the emergency ambulance staff, the patient was lucid, his blood pressure was 80/45 mmHg, pulse rate 47 bpm, and his percutaneous oxygen saturation was 98%. On account of the unremitting chest pain, shallow and fast respiration, and facial pallor, we started hemodynamic monitoring and oxygen supplementation. The chest pain, as well as the unpleasant sensation, resolved gradually. However, the patient needed to be transported to an internal medicine ward, due to significant circulatory suppression. The symptoms completely resolved during transportation, and cardiac catheterization was performed one week after the patient was hospitalized. Thereafter, it was found that the patient did not adhere to his prescribed treatment regimen. In this case, the patient was elderly and did not always comply with his prescribed dosage regimen. This case highlights the need for physicians and other medical staff to confirm compliance with the prescribed medication, and to share such information between each other.
