A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
Figure 1. Index EKG
The patient is a 46 year old female who is presenting for concern of epigastric pain, nausea and vomiting. The patient has a history of chronic nausea, bipolar disorder, diabetes on insulin, and gastroparesis. Given her age and chief complaint, an EKG (Figure 1) was ordered to rule out atypical ACS.
Erica Dolph MD and Ari Edelheit
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Okay team, with spooky season in full swing, let’s talk about some scary stuff . . . chest pain. You’re on red team and they’ve just roomed a 54 year old female with a history of HTN presenting with acute onset chest pain immediately after hearing news that her brother had died, about 30 minutes prior to arrival. The pain is substernal, non-radiating, and described as “pressure-like”. Her systolic BP is in the 150s, but the rest of her vitals are normal. She appears distraught and in pain, but the rest of her exam is unrevealing.
Samson Frendo MD and Eric Leser MD
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Figure 1. Index EKG
A 77-year-old female diabetes and hypertension presents to the emergency department for generalized weakness, shortness of breath, and abdominal pain. A brief initial exam demonstrates that she is in respiratory distress, diaphoretic, tachypneic. The patient is immediately brought to the resuscitation bay and she is found to have an oxygen saturation of 77% on room air and a point-of-care glucose of 500.
Michael Hohl MD and Ari Edelheit MD
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