Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Nov 2004
ReviewMyocarditis: emergency department recognition and management.
Myocarditis is an acute inflammatory syndrome involving the heart and related structures. In many instances, the presentation is obvious, and appropriate treatment and disposition follow accordingly. In other situations, patients present with viral illness of the respiratory or gastrointestinal tracts (or both) or nonspecific symptoms such as fatigue and weakness,leading the clinician astray. Management is largely supportive, including aggressive cardiorespiratory support.
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A neonate presenting to the emergency department can present a challenge to even the most experienced clinician. This article has focused on four deceiving and potentially devastating neonatal diseases. 1. Neonatal herpes is a potentially devastating illness without pathognomonic signs or symptoms. ⋯ Therapy is relatively straightforward and focused on resuscitation followed by prevention of catabolism and correction of specifically identified abnormalities. Although these disorders are relatively uncommon, prompt diagnosis and therapy can lead to a decrease in morbidity and mortality. The key is to maintain a high index of suspicion.
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TAD and AAA are two of the highest risk disease entities in emergency medicine. Emergency physicians should be vigilant in their approach to patients who have symptoms compatible with acute aortic disease. ⋯ Emergency physicians cannot diagnose every case of acute aortic disease; what they can do is practice with a sound understanding of risk management principles and consider these diagnoses in all patients with chest, back, or abdominal pain. Ultimately, this strategy would provide protection for the patient and the physician.