The Singapore Family Physician

Back to issue Vol 39 No. 3 - Emergency Medicine

Pitfalls and Red Flags in Common Clinical Syndromes

Mark Leong Kwok Fai
The Singapore Family Physician Vol 39 No 3 - Emergency Medicine
32 - 36
1 October 2013
Awareness of pitfalls in common clinical symptoms is important. Not all patients with ACS presents with chest pains (beware of patients presenting with syncope, diaphoresis, dyspnoea, pain upper back, etc.). In a breathless patient, anxiety and other psychiatric conditions should only be considered as the diagnosis after careful exclusion of other life threatening causes: metabolic acidosis, partially occluded upper airway, bronchospasm, and pulmonary embolism. In a patient with headaches, intracranial haemorrhage, meningitis/encephalitis, and brain mass lesion need to be considered in the differential diagnosis. The elderly patient presenting with acute abdominal pain will require FPs to maintain a high index of suspicion for potential life threatening causes. Possible causes of serious backache are ACS, AD, AAA, and spinal cord compression. In the wounded patient, there is a need to determine the medical condition that may have resulted in the patient’s injury, and patient’s risk profile is as the wound profile for correct management. In the pregnant patient, dyspnea can be due to pulmonary embolism, or heart failure; placenta abruption from abdominal injury may not have the classical triad of pain, tenderness or vaginal bleeding.