A 68-year-old man Mr. Záruba is coming to the general practitioner. He is a frequent attender as he has got high blood pressure, diabetes and recently high blood cholesterol has been measured too. That is why he has decided to quit smoking and he has been successful for six months already.
He had a smoked pork knee for dinner yesterday and this morning he vomited, had heartburn and complained about uncomfortable chest pressure. On his way to the GP (the ambulance is located on the second floor) he felt short of breath. The following correct step is:
Gastric fibroscopy is not indicated due to the length of vomiting and no blood present in vomitus. You are causing the patient futher stress and wasting the tax payers money.
Whatever happens, the thorough examination and carefully taken history are the cornerstones of diagnostics.
Vomitus and nausea can be the first symptoms of acute myocardial infarction (AMI). It is necessary to think about it. The typical warning pain in the chest can be hidden due to polyneuropathy. The patient with AMI is threatened by sudden cardiac death and every delay in diagnostics or therapy can have fatal consequences.
Gastroenteritis accompanied by vomiting, without diarrhea or elevated temperature is probably caused by a diet mistake or has a viral origin. Giving antibiotics is not indicated in this case and it can worse patient's outcome. Vomitus and nausea can be the first symptoms of acute myocardial infarction (AMI). It is necessary to think about it. The typical warning pain in the chest can be hidden due to polyneuropathy and diminished pain perception.