Select a chief complaint from the following list and provide a list of differential diagnoses and an initial workup for the patient, including laboratory tests, imaging studies, and medications.
- Left lower quadrant pain
- Altered mental status
- Chest pain
- Numbness in an ipsilateral extremities
- Blurring vision that is sudden
- Cold, blue toes
- Heavy, off-scheduled vaginal bleeding
- Genitourinary puss
- Shortness of breath
- Low back pain
- Radiating paresthesia in the back of the legs
- Infectious process requiring antibiotic treatment
The chief complaint selected for this essay is “Chest pain”. Chest pain is a common presentation in the emergency department, and it is important to consider a wide range of differential diagnoses to determine the underlying cause. The initial workup for a patient with chest pain may include laboratory tests, imaging studies, and medications.
- Acute Coronary Syndrome (ACS)
- Pulmonary Embolism (PE)
- Aortic Dissection
- Gastroesophageal Reflux Disease (GERD)
- Anxiety/Panic Attack
- Musculoskeletal Pain
- Electrocardiogram (ECG) – to assess for any changes in the heart’s electrical activity, which can help diagnose ACS and other cardiac conditions.
- Troponin Levels – to detect myocardial injury, which can be indicative of ACS.
- Chest X-ray – to assess for any abnormalities in the lungs or chest wall, which can help diagnose conditions such as pneumonia or costochondritis.
- Computed Tomography (CT) Angiography – to assess for any pulmonary embolism or aortic dissection.
- Echocardiography – to assess for any abnormalities in the heart, including pericarditis.
- Gastric Acid Testing – to diagnose GERD.
- Anti-Anxiety Medications – to treat anxiety/panic attacks.
- Anti-Inflammatory Medications – to treat costochondritis and musculoskeletal pain.
- Antibiotics – to treat pneumonia and other infectious processes.
In conclusion, chest pain is a common chief complaint in the emergency department, and it is important to consider a wide range of differential diagnoses. The initial workup for a patient with chest pain may include laboratory tests, imaging studies, and medications. Prompt diagnosis and appropriate treatment are crucial to ensure the best possible outcome for the patient. It is important for healthcare professionals to remain vigilant and thorough in their assessment of patients with chest pain.