Determining the Cause
a. EKG: Indeterminate
Differential Diagnosis
Myocardial Infarction, Pneumothorax, Aortic Dissection, Esophageal Rupture, Pneumonia, Gastrointestinal Reflux, Perforated Ulcer
| Pivotal Assessments one after the other | 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.