Emergency medicine

A case of sudden, severe, crushing chest pain

Gordian Fulde



Emergencies can spring up at any time and in many incarnations. Are you adequately equipped to deal with them? Each month we present a case study in emergency medicine based on real cases and events. Would you have been able to help this patient?

Article Extract

Interest: personal and professional

A close childhood friend rings you at home one night. He asks you whether you recall a certain family name. At first, you don’t – he jogs your memory. It was the surname of a lovely little girl who died, tragically, from unusual intracerebral pathology; with kids of your own, you do not need any further reminder. He tells you that, last week, the girl’s mother had come into the emergency department where you do some regular shifts. Your friend continues in a sombre tone, and it does not take much intuition to know that you are not going to feel good about the rest of the story.

Early in the conversation, you make it clear that you could tell him nothing about the patient even if you were familiar with the case, as you have no right or permission to disregard confidentiality. You also take quite some effort to point out that, as you only have his – third hand – information to go by, it would be stupid of you to prognosticate. He is OK with this.