- The D-dimer test is a marker of blood clotting activity and is not diagnostic of VTE
- When used appropriately the D-dimer test helps “rule out” VTE if the test is negative and the chance of the patient having a VTE is relatively low
Renal colic mimics
- Some mimics of renal colic that may arrive at the ED include: upper UTI’s, ectopic pregnancies, ovarian torsion, adnexal masses, testicular torsion, acute aortic syndromes, renal artery aneurysms, renal infarction, splenic infarction, bowel obstruction, diverticulitis, appendicitis, biliary colic, cholecystitis, acute intestinal ischemia, pneumonia, pulmonary embolism, retroperitoneal hematoma, iliopsoas abscess.
- Focused history and physical exam are paramount due to the multitude of structures in the area and potentially dangerous conditions that may mimic renal colic.
- Flank pain and hematuria are the hallmarks of renal colic, however, the presentation is variable.
- Diagnosis can be confirmed with CT scan, which will show most other potential items in the differential if the scan is negative for a stone.
Pulmonary Embolism on CXR
The chest x-ray demonstrates the Hampton hump sign, a dome-shaped area of opacification in the periphery of the left lower lobe.
ECG findings among patients with Acute Pulmonary Embolism
ECG findings among patients with acute PE: tachycardia (38%), T-wave inversion in lead V1 (38%), and ST elevation in aVR (36%). significant EKG findings which predicted mortality were:
- Heart rate > 100 beats/min,
- complete RBBB,
- inverted T waves in V1–V4,
- ST elevation in aVR,
- atrial ﬁbrillation