Background: Chest pain and related symptoms are the number two reason patients visit emergency departments in the United States, often leading to routine hospitalization or observation. Improving utilization management of patients presenting to the emergency department with chest pain is an important goal for hospitals. Use of 5th generation troponins and risk stratifying tools can [...]

Background: Uncertain language, specifically for the diagnosis of pneumonia in chest radiograph reports has been noted in previous research studies (1, 2, 3). In fact, as many as 1 out of every 4 chest x-rays (CXRs) are not positive or negative for pneumonia but are uncertain (4). Some uncertain reports use language modifiers that precede [...]

Background: Since the start of the COVID-19 pandemic, racial and ethnic minorities have experienced disparities in infection rates, hospitalization, and death. Monoclonal antibodies (Mab) decrease hospitalization when given to ambulatory non-severe high-risk patients within 10 day of symptom onset. Disparities in care related to Mabs are not well understood. We describe experience from Mab infusion [...]

Background: SARS-CoV-2 (COVID-19) pandemic continues to remain a global crisis with the emergence of new virulent variants, including the recent spikes in the cases of delta variant. While RT-PCR is the diagnostic test of choice, High-Resolution Computed Tomography (HRCT) chest has been utilized to assess disease severity. We aim to study the association between bilateral [...]

Background: Unstable Angina (UA) is a common subset of Acute Coronary Syndrome (ACS) and presents as atypical chest pain without the presence of cardiac biomarkers. It accounts for nearly 550,000 hospital admissions each year in the United States [1]. Management of UA can vary depending on the physician and/or intensity of symptoms. Prior studies have [...]

Background: Epipericardial fat necrosis (EFN) presents as acute chest pain with the potential to mimic life-threatening conditions. It is unclear whether this is truly a rare condition, or simply underdiagnosed by low threshold of suspicion. The literature suggests an estimated prevalence of 2% of EFN as the cause of chest pain in all patients presenting [...]

Background: The diagnostic yield and therapeutic consequences of daily routine chest x-rays are very low. Several studies show discontinuation of daily routine chest x-rays does not affect ICU length of stay, readmission rate, or hospital mortality.We hereby present results of an educational intervention at a tertiary care university medical center to avoid daily routine chest [...]

Background: Recent literature supports risk stratifying patients presenting to the Emergency Department (ED) with undifferentiated chest pain based upon the HEART score. Our institution utilizes the HEART score in a chest pain pathway. Patients with scores of 0 to 3 are typically discharged home after two negative troponins while those with intermediate scores of 4 [...]

Background: Chest pain accounts for 2-5% of all Emergency Room (ER) visits. Tools like TIMI score and HEART score exist to risk stratify patients, but a low threshold for admission has been traditional because the risk of inadvertent discharge of patients with true ACS. In this study, we evaluate the yield of myocardial perfusion scan [...]

Background: Lung ultrasound (LUS) is emerging as a useful diagnostic tool for several lung pathologies. Some studies have found its accuracy in diagnosing pulmonary edema surpasses that of chest x-ray (CXR) but the available evidence is conflicting. CXR currently receives a Class I recommendation by the AHA in the evaluation of decompensated heart failure. Given [...]