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?

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...

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?

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?

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.

Chest pain is common in the ED. What else besides ACS should you consider?

A patient presents with chest pain and hypotension. EKG demonstrates an irregularly irregular rhythm, absent p waves. Is it time to cardiovert? Let's review the management of atrial fibrillation.

The HEART score and pathway have revolutionized evaluation of the chest pain patient in the ED. This pathway can reduce risk of missed major cardiovascular event to < 1%. Many centers utilize the HEART pathway; however, do the score and pathway have a weakness?