
A 59-year-old man has had chest discomfort for several months. He firstnoticed the symptoms when he was doing heavy lifting and moving at work.The discomfort starts in the midsternal region and radiates to the left shoulderand arm. It is often accompanied by diaphoresis, but there is no dizziness ordyspnea. The discomfort always subsides a few minutes after the patientstops the activity that brought it on. More recently, he has experienced similarsymptoms while walking up steep hills on the golf course and dancing at awedding.




































































































































































