Practice Management
A 33-year-old female presents to urgent care with pleuritic chest pain that is gradual in onset over the preceding several days and worse when lying flat. She denies fever, cough, and shortness of breath. She is well appearing with normal vital signs. An ECG is obtained. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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KEY QUESTIONS What features differentiate acute pericarditis from ST-elevation myocardial infarction? What are the criteria for diagnosing acute pericarditis? What are the treatment options?
Read MoreThe patient is a 16-year-old male who presents with difficulty breathing and pain in his throat, along with difficulty swallowing and pleuritic chest pain. All the symptoms began “a couple of hours” prior to presentation. There is no history of trauma or choking, nor of a recent dental procedure. On exam, the patient looks well, and is quiet and not toxic; there are no sign of distress. Pulse is 75, O2sat 94 and there is …
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In our last Bouncebacks article, we explored the difficulties that arise when the patient and doctor disagree on treatment through the case of a 28-year old pregnant patient who left against medical advice (JUCM, February 2009). In the second part of this series, we present a case which explores differences in expectations between a patient and the physicians.
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