A 67-year-old female with past medical history of hypertension presents with acute onset of chest pain without associated symptoms. She describes the pain as left-sided, non-radiating, and 9/10 in severity. On exam, vital signs are normal. She is clutching her chest and is in acute distress due to ...
An 82-year-old female presents to the ED after falling down a flight of stairs. Patient reports falling onto her chest. She endorses right sided chest pain that began immediately after falling but denies any shortness of breath. Vital signs: HR 90 bpm, BP 148/100, RR of 20, T of 98.8F, and SPO2 of...
A 38-year-old male with a history of injection drug use presents with one day of progressively worsening, pressure-like chest pain radiating to his back. He appears diaphoretic and in moderate distress. He has had new difficulty opening his mouth. On exam, he is tachycardic, diaphoretic, and in acut...
A 25-year-old female with no significant past medical history presents with progressive periorbital and lower extremity edema for one week. She denies recent fever, chest pain, shortness of breath, allergies, or recent travel. Vitals include BP 120/90, HR 90, RR 18, Temp 98.7F. Exam shows a developm...
Journal Feed Wrap-Up is all cardiology this week: myocarditis, modified Sgarbossa criteria for ventricular paced rhythms, and guidelines for patients with recurrent chest pain.
A 66-year-old male presents via EMS in respiratory distress. For the past several days he has had worsening productive cough, chest pain, dyspnea, and fever. He appears fatigued, is sitting up in bed, and has increased work of breathing. On exam there is no JVD, 1+ edema, and crackles bilaterally. V...
We review ECGs from 7 patients presenting to the ED with chest pain, all of whom had a computer interpretation as “normal.” And guess what…they all show acute ischemia! Can you see what the computer couldn’t?
A 30-year-old male presents after a motor vehicle accident with chest pain and shortness of breath. He is alert, speaking in 1-2 word responses, and appears in moderate respiratory distress. He has normal left sided breath sounds, but none on the right. No lung sliding is seen with ultrasound examin...
