This patient presents with<unk> <unk>  that is very unlikely angina or acute coronary syndrome.  The emergency department evaluation has not identified any cause for suspicion that this<unk> <unk>  has a cardiac etiology.  Based on their history, EKG (which showed no evidence of ischemia or infarction) and imaging, in addition to the patient's physical exam, I see no evidence at this time for a malignant etiology for the patient's<unk> <unk> .  There is no acute evidence for pulmonary embolus, acute myocardial infarction, pneumothorax, Boerhaeve syndrome, cardiac tamponade, thoracic artery dissection, or any other emergent cardiac, pulmonary or aortic pathology.  Given the low pre-test probability for cardiac etiology of<unk> <unk>  and the absence of any sign of ischemia or infarction, discharge for outpatient follow-up and further evaluation is reasonable.
I have explained to the patient that even though a cardiac problem is very unlikely, follow-up and further testing is required to reduce further the already small uncertainty that exists. Other life-threatening diagnoses have been considered.  The patient understands the need to return immediately if their symptoms worsen or they develop any new symptoms, and not to engage in any significant exertional activity until follow-up is obtained.
Harbor Macros: Chest Pain
Harbor Macros: Abdominal Pain
Harbor Macros: Back Pain
Harbor Macros: Syncope
PALS: Tachycardia
PALS: Bradycardia
ACLS: Tachycardia
Ultrasound: In Shock and Hypotension