Search Results for: chest pain

em@3am

EM@3AM: Pericarditis

A 52-year-old male presents to the ED with chest pain that is left sided, sharp, and worse at night when he is resting flat. It is different from his prior angina. Physical exam is normal, and ECG shows diffuse ST elevations and PR segment depressions. What is the diagnosis?

em@3am

EM@3AM: DVT

A 28-year-old female presents with right lower leg swelling and redness. She just returned from an overseas flight. She denies chest pain or shortness of breath. VS are normal, and her right lower leg is swollen, with diameter > 3 cm compared to her left. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Myocarditis

A 18-year-old male presents with chest pain and shortness of breath for several days. Approximately one week prior he was suffering from myalgia, congestion, sore throat, and fever and was diagnosed with an upper respiratory infection. Today his vitals are HR 132, RR 28, BP 92/48, T 37.8 C, and Sats 95% on RA. What should you consider, and what are your next steps?

em@3am

EM@3AM: Pulmonary Hypertension

A 65F presents to your ED with chest pain and shortness of breath. Her symptoms have been going on for several months and have been progressively worsening. She states that she has felt this way since she was diagnosed with a “blood clot in her lungs” several months ago. VS include T 37.5C, HR 1...

practice updates

ECG Pointers: RBBB in ACS

Often, when we see a RBBB in a chest pain patient, looking for ischemic changes may seem difficult as secondary repolarization abnormalities may be normal findings in V1-V3. So what can we do to help us in picking up ACS changes on the EKG in the setting of a RBBB?

practice updates

Atypical ACS Presentations: How Can We Improve?

Not every patient with acute coronary syndrome presents with retrosternal chest pain. What are the atypical presentations of ACS, and how can we improve our diagnosis of the dangerous masqueraders?

em@3am

EM@3AM – Esophageal Perforation

A patient presents to the ED with chest pain following an upper endoscopy. Initial CXR and gastrograffin esophagram are negative. What do you do? Read on for pearls regarding the management of esophageal perforation.