The 30-year old patient with chest pain

It is a verdict like this that drives defensive medicine:

I see 30-year-olds with chest pain every single day. Like the ER doc in this case, most go home with a reassuring diagnosis and some supportive medication. And I have been lucky — none of them unexpectly dropped dead. And I know, as all ER docs working in the pits know, that if and when one does drop dead, the ER doc (or whomever last touched the hot potato) is going to be blamed. So I test like crazy and just hope that I happen to be ordering the right test on the right patient. Some of what I do is cookbook medicine, but a lot of time the patients don’t read the textbook before coming in, so I have to cast a wide net — what we call using the “shotgun approach.”

Shadowfax with more opinions on the case.

Related posts:

1. A 33-year old man with chest pain
2. A rare cause of chest pain
3. Does your patient really need another chest CT?
4. Chest pain: Cardiac causes always first
5. Chest pain in the ER
6. Chest pain, r/o MI
7. "Daddy . . . I have chest pain"

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