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It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chestpain, weakness and nausea. The patient was transported to the CCU for further medical optimization where a pulmonary artery catheter was placed. NEJM 362(9):779; March 4, 2009.
A man in his 60's presented after 4 days of chestpain, with some increase of pain on the day of presentation. Exact pain history was difficult to ascertain. Apr 28, 2009. There was some SOB. He had walked into the ED (did not use EMS). Here is his ECG: There is atrial fibrillation at a rate of 95.
A man in his 60's presented after 4 days of chestpain, with some increase of pain on the day of presentation. Exact pain history was difficult to ascertain. Apr 28, 2009. There was some SOB. He had walked into the ED (did not use EMS). He was in no distress and vital signs were normal. Obviously there is MI.
She denied chestpain and denied feeling any palpitations, even during her triage ECG: What do you think? CXR confirmed bilateral pulmonary edema and bilateral small effusions. J Electrocardiol, 42 (2009), pp. Despite otherwise normal vital signs, she was appropriately triaged to the critical care area of the ED.
Check : [vitals, SOB, ChestPain, Ultrasound] If the patient has Abdominal Pain, ChestPain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Arch Intern Med 2009 Jul 27; 169:1262. Arch Intern Med 2009 Jul 27; 169:1305.
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