Practice Management
The patient is a 36-year-old male with a history of tobacco and alcohol use who presents to urgent care with sudden-onset substernal chest pain and shortness of breath that began 1 hour prior to arrival. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read More
A 65-year-old male with a history of heart failure presents to an urgent care center with shortness of breath of 2 days duration. He denies chest pain, nausea, or vomiting. He reports that he ran out of his medications about a week ago. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Catherine Reynolds, MD, McGovern Medical School, …
Read More
The patient is a 57-year-old female with a history of coronary artery disease, congestive heart failure, and left ventricular thrombus on warfarin who presents with shortness of breath. She denies any bleeding, bruising, dark-colored stools, chest pain, fever, cough, or leg pain. On evaluation, the patient’s vital signs are normal. She is breathing comfortably and speaking in complete sentences. View the ECG and consider what your next steps and diagnosis would be. Resolution of the …
Read More
A 70-year-old female with history of coronary artery disease presents to urgent care with nonradiating chest pain of 2 days’ duration. She has a known history of left bundle branch block. Baseline ECG: View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Benjamin Cooper, MD, McGovern Medical School, Department of Emergency Medicine, The University of Texas …
Read More
A 38-year-old female with no past medical history presents to an urgent care with right upper quadrant abdominal pain and chest tightness, worsening for 1 week. She reports that her chest tightness is associated with shortness of breath, and is worse when walking and lying on her side. She denies fever, cough, dysuria, headache, or weakness. View the ECG and consider what your diagnosis and next steps would be. (Case presented by Catherine Reynolds, MD, …
Read More
We’ve all seen painful reminders (or experienced them ourselves) of just how helpless natural disasters can leave us. We’ve also been touched and inspired by the bravery and selflessness of first responders—firefighters, police, EMS, and search & rescue personnel—who come to the aid of people in need regardless of their own circumstances. West Virginia University Occupational Medicine is saying thank you by offering a free physical exam for a day at select locations to all …
Read More
Urgent message: Identifying the most likely cause of a 73-year-old male’s sensation that his heart is “missing beats” — while being mindful of the most potentially serious sources—will guide decisions on the right course of action. The ECG you order will offer invaluable clues as to the appropriate steps to take. By John F. O’Brien, MD The patient is a 73-year-old male who presents with a primary complaint that it occasionally feels as if his heart is “missing …
Read More
The patient is a 37-year-old female who presented with a history of longstanding hypertension and diabetes mellitus. She had recently started on a new diuretic, and felt very weak and lightheaded. Her blood pressure was 88/56 mmHg with a pulse of 44 beats per minute. After reviewing the ECG, consider the following questions: 1. Based on this ECG, what type of diuretic is she likely to be taking? 2. How should she be managed?
Read More
The patient is a 32-year-old male who woke up at 1 a.m. with a burning sensation in the mid-chest (a first-time event, he reports). The patient is not diaphoretic, and has no dyspnea. He is generally healthy and has no known risk factors for heart disease. His physical exam is unremarkable. In addition, you find: BP: 154/102 Pulse: 68 Sat: 99% Temperature: 97.3 °F View the EKG taken and consider what your diagnosis and next …
Read More