CASE 587 : POCUS for A CASE of CHEST PAIN, Dr PHAN THANH HẢI , Dr LÊ THANH LIÊM, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Female 92 yo, complaint of a right chest pain and subcostal pain for 5 days that gets more painful when coughing and moving. In emergency examination, she is in consciousness and well contact.

Pouls and blood tension are normal

EKG PoC at bed :Ischemic myocardial  regions in lateral anterior, lateral high  and diaphragmatic of heart.

Chest X-Rays PoC (in supine) results: Cardiopathy due to atherosclerosis, nothing abnormal detected of lungs, pleural and thoracic cage, elevated right diaphragm.

               

Lung Ultrasound PoCUS 
No pneumothorax proved by existing sliding sign (+).

                

No pleural effusion

               

Abdomen Ultrasound PoCUS = No free fluid, no findings of contusion of solid organs = liver, spleen, pancreas, kidneys.

               

Thoracic wal ultrasound PoCUS= Light fracture of 3rd rib anterior arcade without deplacement, and soft tissue around slight edema.

                

CONCLUSION:

 PoCUS at home helps ruling out dangerous conditions like pneumothorax, hemopleuresis, hemoperitoneum, solid organ contusions. PoCUS may evaluate painful points and decide on site (at home) appropriate managements. In face- to - face  contact, PoCUS  may help patient coming down and getting out of anxiety in emergency. 

UPDATE