History of Present Illness:
A woman in her mid 60’s presents to the ER with 24 hours of pain that started between her shoulder blades bilaterally then migrated to her left chest.
Vital Signs & Physical Exam:
Vital signs are all normal. Physical exam is normal
Initial Diagnostic Testing:
- Imaging: POCUS Video – CLICK HERE TO WATCH
What is the diagnosis?
- A) Pinched nerve in the neck on the left
- B) Aortic dissection
- C) ACS
- D) None of the above
SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT
<<<<<<<<<<<<<<<<<<<<< ADVERTISEMENT & SPACER >>>>>>>>>>>>>>>>>>>>>
THE EMERGENCY MEDICINE POCKETBOOK TRIFECTA
Emergency Medicine 1-Minute Consult, 5th edition
A-to-Z EM Pharmacopoeia & Antibiotic Guide, NEW 5th edition
8-in-1 Emergency Department Quick Reference, 5th edition
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What is the most likely diagnosis?
- A) Pinched nerve in the neck on the left – common cause of intrascapular pain and can even cause chest pain but both should be UNILATERAL
- B) Aortic dissection – CORRECT – Always consider with bilateral intrascapular pain. BP in the other arm was NOT normal. It was 193/122
- C) ACS
- D) None of the above
1-Minute Consult on this topic: Click HERE and scroll to proper page
CASE CONCLUSION: went to OR with thoracic surgery for type A aortic dissection
CASE LESSONS: POCUS can expedite the diagnosis in many diseases. Know which ones they are