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Misplaced Concern

      The value of a thorough history is sharply emphasized when only a fragmented medical narrative is available. A 58-year-old man with history of hypertension, cigarette smoking and seizure disorder was found lying on the floor of his house, trembling and confused. Upon arrival at the emergency department, he remained disoriented and could not provide any history.
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      References

        • Douketis J.D.
        • Crowther M.A.
        • Stanton E.B.
        • Ginsberg J.S.
        Elevated cardiac troponin levels in patients with submassive pulmonary embolism.
        Arch Intern Med. 2002; 162: 79-81
        • Ribeiro A.
        • Lindmarker P.
        • Juhlin-Dannfelt A.
        • et al.
        Echocardiography Doppler in pulmonary embolism: right ventricular dysfunction as a predictor of mortality rate.
        Am Heart J. 1997; 134: 479-487
        • Celik T.
        • Yuksel U.C.
        • Kursaklioglu H.
        • et al.
        Precordial ST-segment elevation in acute occlusion of the proximal right coronary artery.
        J Electrocardiol. 2006; 39: 301-304
        • Cafri C.
        • Orlov G.
        • Weinstein J.M.
        • et al.
        ST elevation in the anterior precordial leads during right ventricular infarction: lessons learned during primary coronary angioplasty–a case report.
        Angiology. 2001; 52: 417-420
        • Naccarelli G.V.
        • Antzelevitch C.
        The Brugada syndrome: clinical, genetic, cellular and molecular abnormalities.
        Am J Med. 2001; 110: 573-581
        • Tada H.
        • Aihara N.
        • Ohe T.
        • et al.
        Arrhythmogenic right ventricular cardiomyopathy underlies syndrome of right bundle branch block, ST-segment elevation, and sudden death.
        Am J Cardiol. 1998; 81: 519-522
        • Surawicz B.
        • Parikh S.R.
        Prevalence of male and female patterns of early ventricular repolarization in the normal ECG of males and females from childhood to old age.
        J Am Coll Cardiol. 2002; 40: 1870-1876
        • Rodger M.
        • Makropoulos D.
        • Turek M.
        • et al.
        Diagnostic value of the electrocardiogram in suspected pulmonary embolism.
        Am J Cardiol. 2000; 86: 807-809
        • Chou T.-C.
        Electrocardiography in Clinical Practice.
        in: 2nd ed. Grune & Stratton, Orlando, Fl1986: 309-317
        • Punukollu G.
        • Gowda R.M.
        • Vasavada B.C.
        • Khan I.A.
        Role of electrocardiography in identifying right ventricular dysfunction in acute pulmonary embolism.
        Am J Cardiol. 2005; 96: 450-452
        • Falterman T.J.
        • Martinez J.A.
        • Daberkow D.
        • Weiss L.D.
        Pulmonary embolism with ST segment elevation in leads V1 to V4: case report and review of the literature regarding electrocardiographic changes in acute pulmonary embolism.
        J Emerg Med. 2001; 21: 255-261
        • Livaditis I.G.
        • Paraschos M.
        • Dimopoulos K.
        Massive pulmonary embolism with ST elevation in leads V1-V3 and successful thrombolysis with tenecteplase.
        Heart. 2004; 90: e41
        • Geibel A.
        • Zehender M.
        • Kasper W.
        • et al.
        Prognostic value of the ECG on admission in patients with acute major pulmonary embolism.
        Eur Respir J. 2005; 25: 843-848