LAUSR

A 21-year-old man presented to the emergency department (ED)3 with chest pain, worsening shortness of breath, lethargy, nausea, vomiting, and palpitations. He presented to another ED the previous day with similar symptoms and was sent home with a diagnosis of anxiety and panic attack. His only relevant past medical history was repaired Chiari malformation. There was no family history of ischemic heart disease. His lipid concentrations were as follows: total cholesterol, 79 mg/dL [2.05 mmol/L; reference interval (ref), <200], HDL cholesterol, 26 mg/dL (0.67 mmol/L; ref, 40–199), LDL cholesterol, 22 mg/dL (1.14 mmol/L; ref, 0–129), triglycerides, 43 mg/dL (0.49 mmol/L; ref, 0–150), and he had a BMI (body mass index) of 29. The patient was otherwise in normal health. On arrival, his troponin I was 47.94 ng/mL (Siemens Dimension; ref, 20.0 pg/mL (30.8 pmol/L; ref, 2.4–4.2). View this table: Table 1. Selected laboratory results.a ### QUESTIONS TO CONSIDER 1. What are some causes of decompensated …