Chest Pain

Determining the Cause

a. EKG: Indeterminate

Differential Diagnosis

Myocardial Infarction, Pneumothorax, Aortic Dissection, Esophageal Rupture, Pneumonia, Gastrointestinal Reflux, Perforated Ulcer

Pivotal Assessments Finding
Transthoracic Echocardiography* Wall motion abnormality Normal Wall Motion      
Serial EKG** ST Segment Elevation       Remains Normal

 

Troponin Level

 

Elevated Normal
D-Dimer Level Less than 500ng  
CT Scan Intimal Flap Hyperlucent area in the hemithorax

 

 *Transthoracic echocardiography for assessment of wall motion should be considered for patients with suspected ACS but a nondiagnostic ECG.

**Serial EKGs over short intervals should be performed in patients with a high suspicion of ACS. 

 

Determining the Cause

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