Journal of Urgent Care Medicine

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, …

Boerhaave Syndrome in a 41-Year-Old Female

Urgent message: While Boerhaave syndrome is a rare finding, a relatively high number of cases may present in the urgent care setting. As such, awareness of and vigilance for related symptoms are essential to taking a proper history and, ultimately, early diagnosis of acute, subacute, or chronic Boerhaave syndrome. John Shufeldt, MD, MBA, JD, FACEP, Amber Hawkins, and Carli Nichta, MS4 Introduction Boerhaave syndrome is a spontaneous esophageal rupture indicated in some cases by …

An 18-Year-Old Female with Sudden-Onset Chest Pain

An 18-year-old female presents to your urgent care center complaining of sudden-onset, sharp chest pain. She denies any trauma. View the image taken and consider your next steps, along with possible diagnoses.

Case Report: A 17-year-old Boy with Pneumomediastinum

Urgent message: Although free air in the mediastinum is generally a benign, self-limited condition, most patients should be admitted to the hospital and observed for signs of serious complications, which could be fatal. By Tracey Quail Davidoff, MD A previously healthy 17-year-old male presents to urgent care with a one-week complaint of sore throat, fever, and nasal congestion. On the last day, he had experienced sharp chest pain, which worsened with deep inspiration, swallowing, and …

Pneumomediastinum with No Pneumothorax

Mr. J.V. is a 28-year-old white male who presented to urgent are with a six-hour history of chest pain described as pressure in the sternal area radiating to the left shoulder; back pain was a 5/10 at time of visit, and constant with no accompanying nausea, dizziness, vomiting, or diaphoresis. The patient described an inability to breathe deeply and a sensation of water stuck in the mid esophagus when drinking. Of note, he had similar …