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On January 25, 1993, while loading boxes at work, Darrel Johnson experienced substernal chest tightness, radiating to his right arm, shortness of breath and diaphoresis (sweating), which resolved in five to ten minutes with rest. 911 was called. Mr. Johnson was taken to the St. Francis Hospital Emergency Department for evaluation. The emergency department physicians did all of the right things. Mr. Johnson had a family history of heart disease, a high non-fasting cholesterol, was a 20-year smoker, and had one prior episode of chest symptoms two days earlier while waxing his car. The ER evaluation ruled out myocardial infarction as the source of the symptoms, leaving angina (myocardial ischemia) at the top of the differential diagnosis. The defendant-internist, Dr. Thanh Truong, then admitted the patient for further evaluation. Dr. Truong's plan was to monitor Mr. Johnson overnight, and, if there was no recurrence of symptoms, to perform stress electrocardiography
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