We report the case of a 25-year-old military man (75, 174 cm), with no relevant medical history, who came to the Emergency Room of the Advanced Place of Combat «ugan, continuous movement and pain irradiating».
He had neither fever nor previous infection.
Physical examination showed no increase in jugular venous pressure, pulmonary auscultation was anodyne and cardiac auscultation revealed rhythmic cardiac tones, without pericardial friction.
The following vital signs were recorded: NIBP: 115/73 mmHg, HR: 83 bpm and basal SpO2: 98%.
The ECG showed a J-point elevation with slight ST-segment elevation in almost all leads (except aVR and V1).
Associated with these findings, an echocardiogram showed preserved visual LVEF with good RV function and absence of pericardial effusion.
It was impossible to carry out laboratory tests for not having this capacity in the abovementioned Emergency Room.
If a telematic consultation could be carried out with the Central Hospital of the Defense «Gómez Ulla» (Madrid) through the means of telemedicin available in the Medical Emergency Room with a diagnosis,
After this, and in the absence of prognostic markers, it was decided to keep the patient in absolute rest, instituting treatment with ibuprofen 600 mg early v.o. in order to assess each electrocardiogram changes and echocardiograms badly.
The evolution was satisfactory, remitting chest pain on the third day and presenting total recovery 7 days after the onset of symptoms.
