MDM //

Patient is presenting with atypical chest pain, possibly mskt vs pleuritis vs gastritis. Patient is low risk for ACS. History is atypical and inconsistent for unstable angina. Not suggestive of aortic dissection: pain is not tearing radiating to the back, no neurologic signs. No signs of pneumonia and afebrile, not septic. No risk factors for PULMONARY EMBOLISM, no leg swelling, no recent travel, no hx of clots, no hypoxia, no hormone use. No history to suggest esophageal rupture. Vitals normal, not tension pneumothorax and breath sounds equal bilateral. Exam not consistent for pericarditis or tamponade. Will obtain EKG, CXR, labs, and reassess. Reassessment: EKG not suggestive of STEMI or ischemia. CXR mediastinum is not wide, no pleural effusion, not suggestive of aortic dissection, no evidence of pneumonia or pulmonary edema. Troponin negative *** D dimer negative HEART score *** Will treat symptomatically and recommend follow up with primary doctor in 2-3 days for a recheck and further evaluation. Strict return precautions given. All questions answered. Vitals stable and patient ready for discharge.



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