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.