Classic symptoms of appendicitis include pain that is initially vague and periumbilical followed by a more localized parietal pain in the right lower quadrant. Only 50% of people present with these classic symptoms; in the other 50%, appendicitis can be difficult to diagnosis.
Polyuria is the passing of excessive volumes of urine. Urine output depends on fluid intake and body losses, and typically ranges from 1-3.5 L/day. Polydipsia, the ingestion of excessive volumes of fluid, is usually a consequence of polyuria.
In the ED patient with syncope, the ECG should be scrutinized for signs of ischemia, bradydysrhythmias, tachydysrhythmias, and conduction delays. Critical diagnoses to consider that can be detected with the ECG include: Brugada syndrome, Long or short QT syndromes ...
Shortness of breath (dyspnea) is the subjective sensation of breathlessness which is excessive for any given level of activity. It is important to remember that any component of the respiratory system can cause dyspnea.
Diuretics may not be the preferred initial therapy, however, for those patients with vascular failure, who are often euvolemic, or those with cardiogenic shock, who are often hypovolemic. In these patients, the emergency provider should first optimize preload and afterload reduction with the use of noninvasive positive pressure ventilation (NPPV), nitrates, or inotropes as indicated.
Always check what the patient means by "palpitations" or clarify what you mean, as the word means different things to different people. It is usually understood as an awareness of the heartbeat. The most common cause is an arrhythmia, although other causes include conditions causing an increase in stroke volume (e.g., regurgitant valvular disease) or conditions causing an increase in cardiac output, often noncardiac causes (e.g., exercise, thyrotoxicosis, anemia, or anxiety).
In recent years, there are increasing data that support the use of high-dose vasodilator therapy as the initial treatment for patients with acute decompensated heart failure (ADHF)
Coughing is a nonspecific reaction to irritation anywhere in the respiratory tract from the pharynx to the lungs, and it is the most common manifestation of lower respiratory tract disease. Any cough that persists for over 3 weeks merits further investigation in the absence of an obvious cause.
Acetylcholine (ACh) is too rapidly hydrolyzed and inactivated by acetylcholinesterase (AChE) to be of any therapeutic use; however, its action can be mimicked by other substances, namely direct or indirect parasympathomimetics (cholinomimetics).
There are numerous conditions that cause ST-segment elevation (STE) on an ECG that are not attributable to an acute coronary syndrome. In order to avoid errors in diagnosis or management, it is important for the EP to know the differential diagnosis for STE.