Chest pain is left-sided and worse with activities-breathing

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Reference no: EM133929059

Question

A 33-year-old woman is brought to the emergency department with chest pain for the past day. Her chest pain is left-sided and worse with activities and breathing. She has also noted dyspnea. Her past medical history is significant for systemic lupus erythematosus (SLE), diagnosed ten years ago. She has had a malar rash, oral ulcers, pleuritis, and joint pains due to her condition. She was also diagnosed with lupus nephritis class III 6 years ago and was treated with high-dose corticosteroids and mycophenolate mofetil, which was eventually tapered off two years ago. She is currently taking hydroxychloroquine for her SLE, which has been quiescent for six months. She also has a history of hypertension and hyperlipidemia. Her other current medications include lisinopril and glipizide. On exam, the patient is in distress due to pain and is sweating. Vital signs show pulse rate 110/min, blood pressure 118/73 mmHg, and temperature 98.6 F. The physical exam is otherwise unremarkable. Which of the following is the next best step in managing this patient?

A. Chest X-ray B. 24-hour urinary protein C. Electrocardiography D. IV prednisolone.

Reference no: EM133929059

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