**Figure 1.** Point-of-care echocardiogram demonstrating the D-sign and a trace pericardial effusion.

Consider The Probe: ILD Sign

September 13, 2024

The Case:

The patient is a 64-year-old female with an unknown past medical history who presented to the ED with altered mental status. Her BP was 100/80 mmHg, HR 101 BPM, RR 21 bpm, SPO2 63% on room air, and T 36.8ºC (98.3ºF). The patient was placed on a non-rebreather mask at 15L, and her oxygen saturation improved to 97%. She was given sedatives for acute agitation and delirium. On exam, the patient was tachypneic and had bilateral crackles and decreased breath sounds throughout all lung fields. Her cardiac exam was notable for a regular rhythm without murmur. The remainder of the physical exam was unremarkable.

Michael Hohl, MD

The Heart Of The Matter - A Case of Acute Chest Pain

September 6, 2024

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

The Cheese - The HEART Score

August 30, 2024

“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 County Consult