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PEM Playbook

PEM Playbook – MI in Children

Myocardial infarction (MI) in children is uncommon, but underdiagnosed. This is due to two main factors: the etiologies are varied; and the presenting symptoms are “atypical”.


EM@3AM: 5th Metatarsal Fractures

A 23-year-old female presents with left foot pain after rolling her ankle in volleyball. She has some minor ankle pain, but her lateral foot is painful to touch or with weightbearing. On exam, the base of her 5th metatarsal is tender to palpation, with swelling and ecchymosis. What are your next steps, and what is the likely diagnosis?


US Probe: When Does an Effusion Become Pericardial Tamponade?

Pericardial tamponade occurs when fluid within the pericardial sac impairs filling of the right-sided chambers, leading to a decrease in cardiac output and hemodynamic compromise. It is neither a clinical nor an echocardiographic diagnosis alone. Rather, the echocardiogram carries diagnostic value and should be performed when there is an elevated pre-test probability for tamponade based on the history and physical exam. Here, we will illustrate the core echocardiographic findings of pericardial tamponade.