A 35-year-old woman was admitted to the emergency room after cardiac arrest with pulseless electrical activity. Approximately three weeks before admission, she had fractured her ankle after falling down a flight of stairs. A closed reduction was performed, and a cast was applied. According to her husband, on the evening of admission, the woman stood up from the bed, complained of chest and back pain as well as shortness of breath and nausea. She subsequently fell to the floor and followed with what was described as seizure-like activity with vomiting. Her husband called 911. Upon arrival, the paramedics found the woman on the floor, conscious, complaining of chest pain and nausea. She was oriented to person, place and time, but agitated and somewhat combative. She rapidly became unresponsive, with agonal respirations. The patient was intubated. She subsequently became pulseless. CPR was initiated. List 3 possible DD’s for this woman and include a detailed rationale for each diagnosis that incorporates the patient’s symptoms and the pathophysiology of the disease.
