Chest Pain

Chest pain is one of the most common chief complaints in the emergency department and can be one of the more expensive ones to work up. In an older patient, a complaint of chest pain almost always buys an EKG and labs; often, it gets a hospital stay as a heart attack is "ruled out." Being an intern on cardiology means I get all the chest pain admissions. Often, it is trying to find a needle in a haystack; so many things can cause chest pain and only a minority are cardiac. But what I've learned from this rotation is that the history and physical are key. They teach us this in medical school, and it is true; a thorough history can get you much farther on a diagnosis than any set of laboratory tests. The other common cardiac admission is congestive heart failure. This rotation was really good in helping me review the standards of care and goals in heart failure management. Bread and butter cardiology can get a little boring but is so common and important to review