Journal of Urgent Care Medicine

Abstracts in Urgent Care – November 2024

Sophistication of ECG for Detection of Acute Coronary Syndromes Take Home Point: Cardiac electrical biomarker (CEB), a finding detectable on ECG, may hold potential for identifying patients with acute myocardial ischemia; this may have significant implications for urgent care (UC) based chest pain risk stratification. Citation: Chattopadhyay S, Adjei F, Kardos A. Changes in Cardiac Electrical Biomarker in Response to Coronary Arterial Occlusion: An Experimental Observation. J Cardiovasc Transl Res. 2024 Aug;17(4):870-878. doi: 10.1007/s12265-024-10487-w. Relevance: …

52-Year-Old With Palpitations

A 52-year-old male presents to urgent care complaining of palpitations. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

55-Year-Old Male With Dyspnea

A 55-year-old male with a history of heart failure presents to the urgent care with dyspnea. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

53-Year-Old Female With Fatigue

A 53-year-old female with no significant past medical history presents to the urgent care with progressive fatigue for several weeks. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 75-Year-Old Female with Dizziness and a Slow Heartbeat

The patient is a 75-year-old female who presents with dizziness and a slow heartbeat. She has a history of hypertension. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case begins on the next page.

A 67-Year-Old Male with Chest Pain, Dyspnea, and a History of Lung Cancer

Click Here to download the article PDF. A 67-year-old male presents to urgent care complaining of pleuritic chest pain and dyspnea. He has a history of lung cancer, but denies known cardiac history. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is describe on the next page.

A 55-Year-Old Female with 1 Hour of Chest Pain

A55-year-old female presents to urgent care with chest pain that started 1 hour prior. On exam, she appears diaphoretic with normal vital signs. 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 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 21-Year-Old Male Presents with Altered Mental Status After a Vehicle Accident

KEY QUESTIONS What phenomenon explains the ST elevations in this ECG? What are the features of this condition? What is the clinical significance of this phenomenon?

A 77-Year-Old Man Presents with Dyspnea

KEY QUESTIONS What diagnosis explains the widened QRS? What are the electrocardiographic criteria for making this diagnosis? What rule(s) can help diagnose acute myocardial infarction with an ECG like this?

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