title: [Diagnostic investigation in emergency medicine: Why case history is crucial].
abstract: We present the preclinical case of a patient reporting chest pain. Pain impeded physical examination. Reviewing the patient's detailed medical history after analgesia revealed a connection between the reported pain and vomiting. This led to a suspicion of organ perforation. Thus, the patient was admitted to a surgical emergency room (ER) and Boerhaave's Syndrome was diagnosed. After deterioration in the ER, cardiopulmonal reanimation (CPR), and successful surgical treatment, the patient was transferred to the intensive care unit (ICU) seven hours after first contact.
authors.affiliation: Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Deutschland. martin.mirus@uniklinikum-dresden.de.
authors.forename: M
authors.initials: M
authors.lastname: Mirus
authors.affiliation: Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Deutschland.
authors.forename: A R
authors.initials: AR
authors.lastname: Heller
mesh_terms: D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003933:Diagnosis; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000379:methods*; D004939:Esophageal Perforation / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000601:surgery; D008487:Medical History Taking; D008875:Middle Aged; D014839:Vomiting / Q000150:complications; D004935:Esophageal Diseases; D012422:Rupture, Spontaneous; D000072663:Spontaneous Perforation
keywords: Boerhaave’s syndrome; Chest pain; Diagnostic reasoning; Emergency medicine; Medical history taking