A 70-Year-Old Man With Conspicuous Thigh Pain and ST-Segment Elevations

Area of Science:

• Emergency Medicine
• Cardiology
• Toxicology

Background:

• A 70-year-old male with a history of cerebrovascular disease, hypertension, and recreational stimulant use presented with acute symptoms.
• The patient reported sudden onset left thigh pain and transient chest discomfort.

Observation:

• Physical examination revealed tachycardia (129 bpm) and point tenderness in the left thigh without local inflammatory signs.
• Cardiac auscultation noted an irregular rhythm without murmurs or gallops.

Findings:

• The constellation of symptoms and patient history raised suspicion for an emergent condition potentially related to substance abuse.
• Differential diagnoses included vascular events, musculoskeletal injury, and cardiac ischemia.

Implications:

• This case underscores the need for a broad differential diagnosis in patients presenting with acute pain and cardiac symptoms, especially with a history of substance use.
• Prompt evaluation is crucial to identify and manage potentially life-threatening conditions associated with stimulant use.