Journal of Urgent Care Medicine

Could This Young Patient Really Have a STEMI? A Case Report of a Spontaneous Coronary Artery Dissection

Urgent Message: It is important to quickly obtain an electrocardiogram in patients presenting with chest pain or other symptoms suggestive of acute coronary syndrome, even for those who are young and without traditional coronary risk factors. Citation: Krauss WC. Could This Young Patient Really Have a STEMI? A Case Report of a Spontaneous Coronary Artery Dissection. J Urgent Care Med. 2024; 19 (1):21-23 Key Words: chest pain, spontaneous coronary artery dissection, acute coronary syndrome Abstract …

Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study

Urgent Message: Patients with a moderate-risk HEART score referred from an urgent care center for an expedited outpatient cardiology evaluation were found to have a very low rate of MACE and no occurrence of ischemic cardiac deaths. Citation: Thomson N, Barbarash S, Lebron-Gallagher D, Julson H, Weinstock M. Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study. …

Atypical Chest Pain Reveals Rare T-Cell Lymphoblastic Lymphoma: A Case Report

Urgent message: Not all patients presenting to urgent care with chest pain require immediate transfer to a higher-acuity setting. Rather, immediate evaluation in the urgent care center can inform next steps for management on site or, in the event of truly emergent symptoms, transfer. Tushar Menon, MD; Sahil Kapur, DO; Ameera C. Mistry, MD; and David M. Boyd, MD Key words: T-call lymphoblastic lymphoma, non-Hodgkin’s lymphoma, anterior mediastinal mass, chest pain ABSTRACT Chest pain patients …

A 58-Year-Old Male with Chest Pain

The patients is a 58-year-old male who presents with chest pain. He describes it as sharp, lasting seconds, and worsened by lifting objects at work. Review the initial ECG taken and consider what your diagnosis and next steps could be. Resolution of the case is described on the next page. (Case presented by Tom Fadial, MD, Assistant Professor, McGovern Medical School, The University of Texas Health Sciences Center of Houston.)

A 57-Year-Old Female with Shortness of Breath and Weeks of Chest Pain

The patient is a 57-year-old female who presents to urgent care with progressive shortness of breath and chest pain of “several weeks” duration. On exam, she is nonobese, normotensive, slightly tachycardic, and tachypneic with clear lungs and distant heart sounds. View the initial ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 20-year-Old Female with Chest Pain and SOB

Urgent message: Urgent care providers need to be vigilant for more than acute coronary syndrome, pulmonary embolism, and thoracic aortic dissection when patients present with chest pain—such as this 20-year-old who developed pneumomediastinum while smoking marijuana. Xiangyang Jiao, MD Case Presentation A 20-year-old female presented to urgent care for pleuritic chest pain and shortness of breath for about 2 hours. The chest pain was located in the upper and mid chest, was dull, pressure like, …

A 36-Year-Old Male with Sudden-Onset Substernal Chest Pain

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.

A 75-Year-Old with Chest Pressure

The patient is a 75-year-old male who presents with a primary complaint of pressure in his chest. He denies chest pain, dizziness, or “anything like a heart attack.” View the x-ray taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 61-Year-Old Woman with a 2-Day History of Chest Pain

A 61-year-old female presents to urgent care with chest pain for 2 days. She describes it as “mild right now” but that it varies in intensity; it was so severe the previous night that it kept her from sleeping. Today the pain has been stuttering, lasting a couple of minutes at a time. Pain is substernal, nonradiating, and is associated with vomiting and diaphoresis. Vital signs are normal. View the ECG and consider what your …

A 70-Year-Old Female with Nonradiating Chest Pain

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 …

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