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There are a number of reasons for chest pain.1. Heart - angina or myocardial infarction will cause central crushing pain, often radiating upwards towards jaw and left arm. Clamminess, Shortness of breath, nausea, feelings of doom are also symptoms of an acute MI Angina would occur periodically especially on exertion. A diagnosis of angina is usually made on a full history of when symptoms occur and what makes them better eg rest or Glyceryl trinitrate spray. There are other conditions relating to inflammation of heart muscle/valves and walls which can cause central chest pain.2. Lungs- inflammation of lining/muscles might cause central chest pain although usually associated with shortness of breath. Also a Pulmonary Embolism would cause chest pain and usually shortness of breath3. Esophagus/Stomach - problems with the digestive tract can cause central pain and discomfort. There are a number of different problems including esophageal stricture, hiatus hernia, trapped gas , stomach ulcer to name a few. Pain on right side may also be related to liver or gall bladder.As you can see there are a variety of possible causes so treatment recommendations cannot be made until we identify exact cause. Anxiety and panic attacks can also be associated with chest pain.
The fact that it was eased with Nitro pills indicates a likelihood that there was a problem with constricted blood vessels, but the fact that the EKG was normal could suggest the pain is due to other causes. She should have her levels of cardiac enzymes checked. And a repeat EKG done if the pain returns.
For the blood pressure to be low that could cause the pain through reduced perfusion without an underlying problem like angina.
She must have this low blood pressure addressed. In the short term by increasing fluids however she needs investigation if the blood pressure does not stabilize at a higher level.
Do you know how the rest of her health is?
Does she drink much alcohol?
Thank you for the extra information. With a low potassium and low blood pressure then she will need to be evaluated by her family doctor. I would suggest kidney function tests and possibly a cardiac echo to see how effectively her heart is acting a pump.
If she appears unwell over the weekend with return of the pain or new symptoms such as shortness of breath then return to the ER.