A 72-year-old white male presented to his primary-care physician with a history of left chest pain for the past month. The pain was dull and constant and radiated to the back, medial to the scapula. He denied a new cough or worsening shortness of breath. He had no recent weight loss, and his appetite was good. He had a history of hypertension, which was currently controlled medically, and a significant 60 pack-a-year smoking history. In addition, he suffered a myocardial infarction (MI) 5 years ago. The patient denied any history of claudication, transient ischaemic attacks or stroke. He had undergone surgery in the past for bilateral inguinal hernias, and underwent cardiac catheterization after his MI.
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