Determining the Cause
a. EKG: Normal
Differential Diagnosis
Myocardial Infarction, Pneumothorax, Aortic Dissection, Esophageal Rupture, Pneumonia, Gastrointestinal Reflux, Perforated Ulcer, Aortic Insufficiency
| Pivotal Assessments | Finding | ||||
|---|---|---|---|---|---|
| Serial EKG* | ST Segment Elevation | Indeterminate | Remains Normal | ||
| Transthoracic echocardiograph*** | |||||
Troponin Level
|
Elevated | Normal | |||
| D-Dimer Level | Less than 500ng | ||||
| CT Scan | Intimal Flap | Hyperlucent area in the hemithorax | |||
*Serial EKGs over short intervals should be performed in patients with a high suspicion of ACS.
**Transthoracic echocardiography for assessment of wall motion should be considered for patients with suspected ACS but a nondiagnostic ECG.