The first possible diagnosis I consider is pneumothorax because: -
Right sided chest pain increased by activity, - Cardiac electrical
rotation on the longitudinal axis.
I'd like to have a chest x-ray to confirm or exclude pneumothorax. If
chest x-ray is normal I'll consider pulmonary embolism and I'd like to
have an ELISA D-dimer. If D-dimer is increased it's necessary to have a
pulmonary V/Q scan. If V/Q scan is normal it's necessary to confirm or
exclude great vessels, parietal or mediastinal pathologies with a chest
CT.
Competing interests:
None declared
Competing interests:
No competing interests
20 February 2006
Cleante Scarduelli
Medical Doctor Cardiopulmonary Rehabilitation
Presidio riabilitativo multifunzionale di Bozzolo via XXV Aprile 46012 Bozzolo Italy
Rapid Response:
First I think of pneumothorax
The first possible diagnosis I consider is pneumothorax because: -
Right sided chest pain increased by activity, - Cardiac electrical
rotation on the longitudinal axis.
I'd like to have a chest x-ray to confirm or exclude pneumothorax. If
chest x-ray is normal I'll consider pulmonary embolism and I'd like to
have an ELISA D-dimer. If D-dimer is increased it's necessary to have a
pulmonary V/Q scan. If V/Q scan is normal it's necessary to confirm or
exclude great vessels, parietal or mediastinal pathologies with a chest
CT.
Competing interests:
None declared
Competing interests: No competing interests