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Atypical or typical, is this the question?

I t is a busy day in your ED: A 60 y/o female refers a retrosternal pain radiates to right arm that lasts more than 20 minutes. A 50 y/o male refers a pressure in his chest, with tachycardia and sweating. A 75 y/o female refers a sharp and stabbing pain exacerbates by forceful breathing.…

ByCiro Paolillo8 December 20120Comments

Chest

Can we fight against Pulmonary Embolism using the LR’s arrows?

A 80 y/o woman presented to the ED for dyspnoea. She underwent a knee replacement 2 weeks ago, RR is 24, O2 saturation is 88%. HR is 90, the knee is edematous. You are going to hunt a pulmonary embolism (PE) While you phone the radiologist for a thorax CT scan you have an idea:…

ByCiro Paolillo31 October 20120Comments

Chest

Chest X-Ray and aortic dissection

A 70 yo man come to the ED for restrosternal chest pain and shortness of breath during minimal activity in the last days. He is an ex smoker, with a history of hypertension. On physical examination the patient is not in distress, with a regular blood pressure and regular oximetry. ECG shows no evidence of…

ByCiro Paolillo28 June 20120Comments

Chest

Acute Dyspnoea and Laboratory

I t’s a dark night when a red code arrive at the ED by ambulance. Paramedics tell you: “called for acute dyspnoea, I think it’s a COPD exacerbation, he is wheezing, I gave him bronchodilators and steroids, but he is worsening”. He has a history of COPD and hypertension. He presents sweaty, dyspneic,…

ByIlenia Spallino5 November 20110Comments

Chest Ultrasound

Acute dyspnoea and Lung Ultrasound

It's a dark night when a red code arrive at the ED by ambulance. Paramedics tell you: “called for acute dyspnoea, I think it’s a COPD exacerbation, he is wheezing, I gave him bronchodilators and steroids, but he is worsening”. He has a history of COPD and hypertension. He presents sweaty, dyspneic, arterial…

ByIlenia Spallino31 October 20110Comments

Chest

Acute dyspnoea and X-Ray

I t's a dark night when a red code arrive at the ED by ambulance. Paramedics tell you: “called for acute dyspnoea, I think it’s a COPD exacerbation, he is wheezing, I gave him bronchodilators and steroids, but he is worsening”. He has a history of COPD and hypertension. He presents sweaty, dyspneic,…

ByIlenia Spallino18 October 20110Comments

Chest

Acute dyspnoea and clinical findings

I t's a dark night when a red code arrive at the ED by ambulance. Paramedics tell you: “called for acute dyspnoea, I think it’s a COPD exacerbation, he is wheezing, I gave him bronchodilators and steroids, but he is worsening”. He has a history of COPD and hypertension. He presents sweaty, dyspneic, arterial pressure…

ByIlenia Spallino5 October 20110Comments

Chest

D-dimer and Aortic dissection

It’s 3.00 am when a 55 yo man is accompained to the ED by his wife because of sudden onset precordial pain, he has not clinical history, he does not smoke and he has an active life style, you find a normal blood pressure and clinical examination and a normal ECG, but the pain is…

ByIlenia Spallino17 May 20110Comments