Description
An eighty-three year old man was admitted with central chest pain. An electrocardiogram showed an acute inferior myocardial infarction. He was a heavy smoker and had a past history of osteoarthritis and carcinoma of the colon, which had been resected thirteen years earlier. His medications were co-proxamol, diclofenac and ferrous sulphate. Streptokinase was given but he developed complete heart block requiring the insertion of a temporary pacing wire, which was removed after three days, and he was subsequently discharged after one week. Ten days later he was readmitted with a sudden onset of mid thoracic back pain exacerbated by movement. On examination he was apyrexial; there was no spinal tenderness and the rest of the physical examination was unremarkable.
