Journal of Urgent Care Medicine

The Role of Urgent Care Centers in Regional Acute Coronary Syndrome Care

Urgent message: Patients with chest pain/acute coronary syndrome often present in outpatient medical settings—including urgent care centers—not designed to treat life-threatening conditions. Exclusive new data suggest that urgent care centers need to be integrated into pre-hospital cardiovascular care pathways. JASON T. WEINGART, MD, THOMAS P. CARRIGAN, MD, MHSA, LEE RESNICK, MD, DANIEL ELLENBERGER, BS, DANIEL I. SIMON, MD, and RICHARD A. JOSEPHSON, MS, MD Emergency medical services and hospital-based emergency departments (EDs) are typically incorporated …

17-year-old male has persistent chest pain

The patient, a 17-year-old male, presented with a family member to an urgent care center with a history of chest pain for 2 weeks He denied shortness of breath, radiating pain, fever, or any other similar symptoms. His vital signs were stable.

Clinical Challenge: April, 2012

In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of determining conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please email the relevant materials and presenting information to [email protected]. The patient, a 45-year-old man, presented with vomiting and chest pain. View the image taken (Figure 1) and consider what your diagnosis would be. > Resolution of …

February 2012

Spontaneous Pneumothorax

Urgent message: In patients with chest pain, check chest films carefully to avoid missing an uncommon diagnosis. Joseph Toscano, MD Introduction The traditional differential diagnosis for chest pain includes spontaneous pneumothorax. Chest x-ray is necessary for confirming the diagnosis, and sometimes the findings can be subtle. As in dealing with any infrequently encountered condition, clinicians should consider the diagnosis and closely examine every chest film they order to avoid missing this uncommon diagnosis. Case Presentation …

21-year-old patient with chest pain on the left side

This 21-year-old patient presented with chest pain on the left side and fever. View the image taken and consider what your diagnosis would be.

33-year-old patient presenting vomiting and chest pain

This 33-year-old patient presented with pain in the left side of the chest. The patient was vomiting and not tolerating PO. View the image taken and consider what your diagnosis and next steps would be.

Acute MI After a Normal Stress Test

Urgent message: Evaluation of chest pain in the low-risk patient can be daunting. This case, in which the patient had no known history of cardiovascular disease, exemplifies the challenge. MARREN J. WEBER, DO The standard treadmill exercise tolerance test (ETT) and echocardiography are widely used as the initial tests of choice for prediction of cardiovascular disease. Historically stress echocardiography has been recognized to perform well in predicting mortality in conjunction with clinical data and other …

Chest Pain