A 65-year-old male is brought by ambulance to the Emergency Department with prolonged chest pain, which began during intercourse. Initially, he was awake and alert with a pulse rate of 110/min and a blood pressure of 160/100. The ambulance paramedic gave him aspirin 150 mg and one sublingual glyceryl trinitrate 5 minutes before arrival in the ED. His blood pressure is now 70 systolic with a heart rate of 120/min. He is drowsy but rousable and is still complaining of chest pain. His regular medications are aspirin, pravastatin, isosorbide mononitrate and anginine, which he takes 2-3 times a week. An ECG shows sinus tachycardia and lateral ST depression.
A 3-year-old is brought to hospital after ingesting one of his grandmother’s enalapril tablet 30 minutes ago. The child will not drink charcoal.
A 56-year-old male with a history of hypertension and ischaemic heart disease presents after ingesting 30 300 mg irbesartan tablets with alcohol 2 hours previously. He is drowsy but rousable and orientated. HR is 90/min and BP 160/95.