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Differential Diagnosis of Cardiopulmonary Disease
A Handbook
Charles V. Pollack, Jr.
Editor
Differential Diagnosis of Cardiopulmonary Disease
Editor
Differential Diagnosis of Cardiopulmonary Disease
A Handbook
Editor
CharlesV.Pollack,Jr. Department of Emergency Medicine Thomas Jefferson University Philadelphia, PA, USA
ISBN 978-3-319-63894-2 ISBN 978-3-319-63895-9 (eBook)
https://doi.org/10.1007/978-3-319-63895-9
Library of Congress Control Number: 2019935819
© Springer Nature Switzerland AG 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specic statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Preface

This book is intended to be a ready resource and guide for the evaluation of com­mon symptoms and syndromes that originate in the primary cardiopulmonary sys­tem. It should prove particularly useful in the generation of a working differential diagnosis, consideration of diagnostic approach, and initial management decisions. It is not intended to be a comprehensive resource; rather, it follows the classic “emergency medicine approach” of considering rst the worst-case scenario, and then exploring other possibilities quickly and efciently. The image, video, and audio links embedded in the text should help the learner correlate bedside ndings with reference material.
It is our hope that this guide will streamline the diagnostic approach to patients with “thoracic” complaints and make the learner more condent in his or her skills. The focus of this book is on differential diagnosis, conrmation of diagnosis, and essential steps towards initiating treatment. Therapeutic modalities change more rapidly that diagnostic approach and may have evolved since a specic chapter was completed. Treatment should always be guided by the latest literature, but is founded upon solid diagnostic acumen.
Philadelphia, PA, USA Charles
V.Pollack,Jr.
v

Contents

1 Achalasia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Christopher J. Rees, Victoria G. Riese, and Charles V. Pollack, Jr.
2 Acute Coronary Syndrome: Non–ST-Segment Elevation
Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Charles V. Pollack, Jr. and Victoria G. Riese
3 Acute Coronary Syndrome: ST-Segment Elevation Myocardial
Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
4 Acute Coronary Syndrome: Unstable Angina . . . . . . . . . . . . . . . . . . 73
Charles V. Pollack, Jr. and Victoria G. Riese
5 Acute Pericarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
6 Anomalous Coronary Arteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
7 Anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
8 Aortic Regurgitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
9 Aortic Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, and Victoria G. Riese
10 Aspiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
vii
viii
Contents
11 Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, and Victoria G. Riese
12 Atrial Fibrillation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Charles V. Pollack, Jr., Melissa Platt, and Victoria G. Riese
13 Bradyarrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
14 Bronchiectasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
15 Bronchiolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
16 Carbon Monoxide Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, Victoria G. Riese, and Jaime Friel Blanck
17 Chest Neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
18 Chronic Obstructive Pulmonary Disease . . . . . . . . . . . . . . . . . . . . . . 277
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
19 Cor Pulmonale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Jaime Friel Blanck
20 Costochondritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
21 Cyanide Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, and Victoria G. Riese
22 Cyanotic Congenital Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
Richard M. Cantor, Charles V. Pollack, Jr., and Jaime Friel Blanck
23 Cystic Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339
Richard M. Cantor, Charles V. Pollack, Jr., and Jaime Friel Blanck
24 Diabetic Ketoacidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Jaime Friel Blanck
25 Duchenne Muscular Dystrophy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379
Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
Contents
26 Epiglottitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391
Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
27 Esophageal Rupture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
28 Esophagitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
29 Foreign Body Aspiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
30 Gastroesophageal Reflux Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
31 Goiter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451
Christopher J. Rees, Charles V. Pollack, Jr., and Jaime Friel Blanck
32 Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 471
Charles V. Pollack, Jr. and Victoria G. Riese
33 Hemoptysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 493
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
34 Herpes Zoster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 505
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
ix
35 Hiatal Hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 515
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
36 Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 525
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
37 Hypertrophic Cardiomyopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 545
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
38 Idiopathic Pulmonary Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 557
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
39 Infective Endocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 575
Christopher J. Rees, Charles V. Pollack, Jr., and Jaime Friel Blanck
40 Interstitial Lung Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 595
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
41 Ischemic Cardiomyopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 613
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, and Jaime Friel Blanck
42 Kawasaki Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 625
Richard M. Cantor, Charles V. Pollack, Jr., and Jaime Friel Blanck
x
Contents
43 Laryngospasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 643
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, and Victoria G. Riese
44 Mallory-Weiss Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 653
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
45 Mediastinal Masses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 661
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
46 Mediastinitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 669
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
47 Mitral Valve Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 679
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
48 Mitral Valve Regurgitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 693
Charles V. Pollack, Jr. and Jaime Friel Blanck
49 Mitral Valve Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 707
Charles V. Pollack, Jr. and Jaime Friel Blanck
50 Myocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 719
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
51 Neuromuscular Disease: Myasthenia Gravis, Guillain-Barré,
Amyotrophic Lateral Sclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 743
Charles V. Pollack, Jr. and Jaime Friel Blanck
52 Noncardiogenic Pulmonary Edema . . . . . . . . . . . . . . . . . . . . . . . . . . . 759
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, and Victoria G. Riese
53 Peptic Ulcer Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 769
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
54 Pericardial Effusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 779
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, and Jaime Friel
55 Pleural Effusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 797
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, and Victoria G. Riese
56 Pleurisy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 809
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
57 Pneumoconiosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 819
Christopher J. Rees, Charles V. Pollack, Jr., and Victoria G. Riese
Contents
58 Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 837
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
59 Pneumothorax (Simple) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 853
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
60 Pneumothorax (Tension) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 875
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
61 Pulmonary Embolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 889
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
62 Pulmonary Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 911
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, Victoria G. Riese, and Jaime Friel Blanck
63 Pulmonary Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 919
Christopher J. Rees, Charles V. Pollack, Jr., and Jaime Friel Blanck
64 Radiation Pneumonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 945
Christopher J. Rees, Charles V. Pollack, Jr., and Jaime Friel Blanck
65 Retropharyngeal Abscess . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 963
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
xi
66 Sarcoidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 973
Christopher J. Rees, Richard M. Cantor, Charles V. Pollack, Jr., and Victoria G. Riese
67 Sepsis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 995
Charles V. Pollack, Jr., Melissa Platt, Richard M. Cantor, and Jaime Friel Blanck
68 Tachyarrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1013
Charles V. Pollack, Jr., Richard M. Cantor, and Jaime Friel Blanck
69 Tetralogy of Fallot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1037
Richard M. Cantor, Charles V. Pollack, Jr., and Jaime Friel Blanck
70 Thoracic Aortic Dissection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1051
Charles V. Pollack, Jr., Richard M. Cantor, and Victoria G. Riese
71 Total Anomalous Pulmonary Venous Connection . . . . . . . . . . . . . . . 1081
Richard M. Cantor, Charles V. Pollack, Jr., and Jaime Friel Blanck
72 Tracheal Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1095
Christopher J. Rees, Charles V. Pollack, Jr., and Jaime Friel Blanck
73 Tracheomalacia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1109
Christopher J. Rees, Charles V. Pollack, Jr., and Jaime Friel Blanck
74 Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1123
Charles V. Pollack, Jr. and Victoria G. Riese