I'm surprised that you didn't mention black widow (and redback) envenomations. Absent a history of an observed bite, the symptoms can be tough to differentiate from chest pain of more serious cause. It is embarrassing to find the spider in the patient's clothes as you are sending him off to the cath lab, or home after an invasive and expensive workup.
I'm reading more about SCAD and how it presents more in young woman with no history of atherosclerotic disease. It used to be considered one of those rare zebras only in textbooks but I'm reading that it's more common than we think.
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Chest Pain in Young PatientsFull episode audio for MD edition82:27 min - 115 MB - M4AC3 2018 04 April Chest Pain in Young Patients Board Review Answers87 KB - PDFC3 2018 04 April Chest Pain in Young Patients Board Review Questions331 KB - PDFC3 2018 04 April Chest Pain in Young Patients Individual MP3 Files101 MB - ZIPC3 2018 04 April Chest Pain in Young Patients Written Summary332 KB - PDF
Rabbott - April 19, 2018 10:19 AM
I'm surprised that you didn't mention black widow (and redback) envenomations. Absent a history of an observed bite, the symptoms can be tough to differentiate from chest pain of more serious cause. It is embarrassing to find the spider in the patient's clothes as you are sending him off to the cath lab, or home after an invasive and expensive workup.
jonathan o. - August 8, 2019 8:19 PM
I'm still getting an EKG in the Axe patient.
Ankur M. - April 8, 2021 8:16 AM
I'm reading more about SCAD and how it presents more in young woman with no history of atherosclerotic disease. It used to be considered one of those rare zebras only in textbooks but I'm reading that it's more common than we think.