The patient is a 20-year-old female who presents with sudden onset of left sided chest pain. A collegiate cross-country runner, she reports that she also felt lightheaded when lacing up her running shoes earlier in the day. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Chronic Cough and Shortness of Breath
A 74-year-old man without a significant past medical history presents to an urgent care center reporting 3 days of coughing productive of green sputum, shortness of breath that worsens with exertion, and chills. He says he has a chronic morning cough but states that the sputum has changed color and that his dyspnea has increased. He says he has not had any fever, chest pain, or lower extremity pain or swelling. View the image taken …
Read MoreMalpractice Trends in Urgent Care and Retail Medicine
JOHN SHUFELDT, MD, JD, MBA, FACEP with ANDREW SNIEGOWSKI, RN, JD CANDIDATE 2014 Over the last 6 years I have written a number of articles on medical malpractice in urgent care medicine. The good news is that I am seeing fewer cases despite the fact that there are more urgent care centers and more patient visits. The bad news is that I am still seeing the same fact patterns time and again. Failure to diagnose …
Read MoreAssessing for Life-threatening Chest Pain in the Urgent Care Center
Urgent message: Data show that urgent care centers are becoming a more common destination for patients experiencing chest pain. Immediate recognition of emergent vs. urgent causes may be the make-or-break moment for the patient’s outcome. Jasmeet Singh Bhogal, MD Introduction Evaluation of chest pain always presents as a diagnostic challenge, be it in the outpatient family medicine setting or the hospital emergency department. In fact, urgent care centers occupy a unique position in the equation; …
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A Patient with Suspected Pulmonary Embolism
Urgent message: High degree of suspicion combined with thorough history and proper use of available tests can help the clinician identify patients in need of emergent referral. John Shufeldt, MD, JD, MBA, FACEP and Kelli Hickle Introduction A 47-year-old woman with a diagnosis of ovarian cancer developed an acute onset of mild shortness of breath two days after being discharged for a work-up of symptomatic ascites. Her medical history was significant for obesity and recent …
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