Expedited Care for a Patient With Uncertain Myocardial Infarction Using Point-of-Care Ultrasound in Critical Access Emergency Medicine: A Case Report

Point-of-care ultrasound (POCUS) is a valuable tool for emergency department (ED) physicians. In this case report, we demonstrate how the use of cardiac POCUS can enhance access to definitive care for emergent cardiac complaints in rural settings lacking the resources of tertiary care facilities. We present the case of a 73-year-old woman who presented to the ED with one hour of chest pain concerning for myocardial infarction versus acute pericarditis. Bedside echocardiography was performed, ruling out pericarditis and establishing the diagnosis. The rapid availability of POCUS reduced diagnostic uncertainty, enabling timely management of an ST-elevation myocardial infarction (STEMI), despite associated health risks and geographical barriers to immediate percutaneous coronary intervention. In order to reduce diagnostic uncertainty, bedside cardiac ultrasound was performed, with results most significant for STEMI. Ultimately, despite geographic barriers, as a result of POCUS, this patient was able to quickly access definitive care for a condition in which "time is tissue," reducing both the potential morbidity and mortality associated with STEMIs.