Question

A 49 y/o female arrives in the ER with persistant epigastric pain. She has been taking antacids PO for the past 6 hours because she she had heartburn. BP is 118/72, heart rate is 92/min, resp. rate is 14 non-labored and O2 sat is 96%. What is the most appropriate next action?

Answer 1

For a 49-year-old female in the ER with persistent epigastric pain and history of antacid use for heartburn, an ECG is the most appropriate next step to rule out cardiac issues, followed by further clinical assessment and possibly endoscopy or medication trials.

Step-by-step explanation:

Management of Persistent Epigastric Pain in ER

A 49-year-old female presenting with persistent epigastric pain after taking antacids for heartburn requires further evaluation. Given her stable vital signs, GERD is a possible diagnosis; however, it is important to rule out other serious conditions such as myocardial infarction or peptic ulcer disease. Therefore, the most appropriate next action would be to perform an ECG to check for cardiac issues and provide prompt management in case of an acute event. Additional clinical assessment, including a detailed history and physical examination, focusing on the character, duration, and aggravating or relieving factors of her pain is also crucial. If the ECG is normal, further investigation could involve endoscopy or trials of proton pump inhibitors depending on the clinical evaluation.