| |
Case#1 10/29/07 The Mailman with Chest Pain Scores!
A 48 y/o mailman presents with chief complaints of chest pain. He smokes ½ pack of cigarettes per day, and he also has a history of HTN (on Hydrochlorothiazide). There is no Family history of heart disease, no history of elevated cholesterol, and he is not diabetic. He has never had a stress test, but did take an Aspirin 5 days ago at the prompting of his wife when he complained of chest pain. His wife made him come in today because he developed recurrent chest discomfort (described as ache, pressure) yesterday and again today. He did get slightly SOB and diaphoretic with each episode. One occurred at rest, the other while helping his wife with the dishes. Each episode lasted less than 5 minutes, and resolved spontaneously. His EKG is normal, and enzymes (all labs) are normal. CXR is normal. You suggest further evaluation, but he wants to leave AMA. His wife wants to know if he is taking a risk by leaving.
1. What is his 30 day risk of MI, death or need for urgent revascularization?
2. What are the different calculators to predict adverse outcomes for USA/NSTEMI?
3. What are the differences and limitations of these calculators?
Click here for answers and to respond
|
|
Previous Articles
|
| |
The EM Forum has been developed as
a service of EMS. Like any other service, in
spite of our best efforts the information in
this Web Site may become out of date over
time. Nothing on this Web Site should be
construed as the giving of advice or the
making of a recommendation and it should not
be relied on as the basis for any decision
or action. It is important that you rely
only on the advice of a health care
professional to advise you on your specific
situation. EMS accepts no liability for the
accuracy or completeness or use of, nor any
liability to update, the information
contained on this Web Site. These materials
are provided "AS IS" WITHOUT WARRANTY OF ANY
KIND, EITHER EXPRESSED OR IMPLIED,
INCLUDING, BUT NOT LIMITED TO, THE IMPLIED
WARRANTIES OF MERCHANTABILITY, FITNESS FOR A
PARTICULAR PURPOSE, OR NON-INFRINGEMENT. |
