Exam without evidence of volume overload so doubt heart failure. EKG without signs of active ischemia. Given the timing of pain to ER presentation, single troponin_ delta troponin_ was _ so doubt NSTEMI.  Presentation not consistent with acute PE (Wells low risk _ PERC negative_),pneumothorax (not visualized on chest xr), thoracic aortic dissection, pericarditis, tamponade, pneumonia (no infectious symptoms, clear chest xr), myocarditis (no recent illness, neg trop). HEART score:_ so plan to admit patient for risk stratification_; discharge patient home with PMD follow up__.
This patient presents with chest pain and an EKG showing _ STEMI or STEMI equivalent (Wellens, de Winter’s, Sgarbossa criteria)_. Patient given aspirin. Pain controlled with _. Presentation not consistent with acute thoracic aortic dissection. No evidence of acute ACS complications including cardiogenic shock (2/2 muscle loss or valvular rupture), tachydysrhythmia or electrical conduction disturbance. Patient taken to cath lab.
Patient presented with chest pain concerning for ACS, EKG was non STEMI, however troponin was elevated concerning for NSTEMI, and the patient was given aspirin and started on heparin, pain was controlled with _, cardiology was consulted and patient was admitted. Patient with no signs of heart failure. Given history and story considered but low risk for aortic dissection, pneumonia, or PE.
MDM for different chief complaints
Critical care documentation
Combative patient
Wilderness preparedness
ACEP clinical policies
Expedited partner therapy
SCVMC:CUSTODY CARE
FALLS protocol