The Case:

An 85-year-old woman with PMHx of inferior MI s/p VVI pacemaker for atrial fibrillation with slow ventricular response comes in to the ED with acute chest pain. An ECG is obtained on arrival (Figure 1).

Michael Hohl, MD

“So what’s the dispo?” The looming question over every Emergency Department patient. Your 63-year-old patient with chest pain has had two normal EKGs and troponins, yet something in your gut is telling you that maybe this person needs admission. But is your gut feeling good enough to warrant admission? Is there any risk stratification tool out there to help you decide? And if so, is it useful and valid?  Here, we discuss a landmark article in Emergency Medicine: “A Prospective Validation of the HEART Score for Chest Pain Patients in the Emergency Department”.

Taylor Wahrenbrock, MD

The Case:

A 49-year-old M without relevant PMHx presented for a month of abdominal pain and post-prandial emesis. He denied chest pain or shortness of breath. Triage vitals were within normal limits, and the following ECG was obtained. He denied any chest pain or shortness of breath now or in the recent past.

Michael Hohl, MD