A 60-year-old man with a history of hypertension and smoking presents to the medical center with chest pain. Over the weekend, he developed chest pain while cleaning out his gutters that resolved with rest. This morning, he was working at his computer when he developed chest pain radiating to his left arm. It has since resolved, but he presents to the clinic for evaluation. An EKG obtained on arrival is unremarkable, but he soon develops chest pain again…
Read More…The differential diagnosis included acute coronary syndrome, CHF exacerbation, pneumonia, and cardiac amyloidosis.
EKG showed sinus tachycardia with low voltage. Laboratory evaluation was unremarkable, with a negative troponin and high normal BNP. Chest radiograph showed bilateral infiltrates concerning for mild pulmonary congestion.
POCUS was obtained….
Read MoreRead the HPI and think about the questions on the title slide before watching the video. Put yourself at the bedside of this patient and form your own diagnostic and management plan. Designed to help you actually rehearse what you’re going to say and do at the bedside of a sick patient, keep tuning in each week for the same format but new and high yield Emergency Medicine pearls…
Read MoreA 58-year-old woman with a past medical history significant for hypertension and hyperlipidemia presents to the Emergency Department with 3 days of dyspnea. She also endorses non exertional pleuritic chest pain, chills, and malaise that started on the morning of her presentation. Vital signs were notable for tachycardia of 110 beats per minute and an oxygen saturation of 93% on room air, but were otherwise normal. Physical exam revealed clear lung fields bilaterally and was otherwise unremarkable…
Read MoreA 57-year-old man presents to the emergency department in the middle of the night complaining of chest pain that woke him up three hours ago. He states that he feels tightness and a burning sensation across both sides of his chest, with intermittent sharp pains that he rates as an 8/10. He also reports that both of his arms are numb and tingling, and the right side of his face has been twitching. He has not been able to go back to sleep because he is so uncomfortable…
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