the case.
a 42 year old male presents via ambulance with chest pain following an motor vehicle accident.
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pulling apart cases from the ED...
the case.
a 42 year old male presents via ambulance with chest pain following an motor vehicle accident.
[Read more…]
The case.
A 76 year old female presents to ED after being repeated assaulted by her aggressive, demented husband, including punches, kicks and attempted strangulation. She has a past medical history of hypertension & GORD and takes telmisartan, amlodipine & pantoprazole.
On examination, she is alert and oriented with a patent airway, complaining of central chest pain and jaw pain. There are ligature marks over the anterior neck, but no haematoma, subcutaneous emphysema or hoarseness of voice. She has significant bruising (of various ages) over her maxilla, mandible, chest wall and thigh.
E-FAST reveals trace free-fluid in the Pouch of Douglas only, so with her normal vital signs she is booked for a CT pan-scan….
Whilst you are writing your notes, the Resus nurse hands you her ECG…
… it appears to be a game-changer ! Suddenly your team questions everything !!
Differential Diagnoses.
What else should we consider ??
Differential Diagnosis of ST-Segment Elevation
Whilst the team is concerned about her ECG changes, it is decided that she should have her neuroimaging prior to administration of antiplatelet therapy. She is rushed off to CT…
The findings;
aka. Stress-induced cardiomyopathy, Apical ballooning syndrome, Broken-heart syndrome.
The Basics.
The Pathophysiology.
Clinical Features.
Investigations.
Diagnosis.
Management.