A 48-year-old man is brought to the emergency department complaining of chest pain. The nurse performs an assessment of the client. Which of the following symptoms, if present, would be most characteristic of an acute myocardial infarction?
1. Substernal pressure-type pain, radiating down the left arm
2. Coli-like epigastric pain
3. Sharp, well-localized unilateral chest and left arm pain
4. Sharp, burning chest pain moving from place to place
Substernal pressure-type pain, radiating down the left arm
Rationale: The clinical manifestations of angina pectoris include a sudden onset of discomfort in the chest, jaw, shoulder, back, or arm, aggravated by exertion or emotional stress. Terms such as burning, crushing, suffocating, and pressure are typical descriptors of chest pain from myocardial ischemia, often with pain radiating to other areas of the upper torso. Cardiac chest pain is not usually described as coli-like, localized to a defined spot such as the epigastric area, or as a sharp pain.
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