Indexing Title: JGUERRA’s Medical Anecdotal Report [04-3]

MAR Title: 23-year-old male with Shoulder dislocation died of Myocardial Infarction?

 Date of Observation: December 2003

Narration:

            At around 11am, a 23M came in at Surgery ER due to a injured L shoulder sustained in a basketball game. Patient was complaining of severe pain and limitation of movement of the affected area that according to him radiates to the anterior chest. Partly, during that time I am a bit worried if the chest pain was cardiac in origin, but being a 23M, with normal vital signs, the possibility of it was remote. He was anxious and was noted to have cold extremities. Xray showed anterior dislocation of the shoulder joint. Condition was explained and he consented for a close reduction. Immediately it was reduced and the patient was sent home. Still the patient complained of shoulder pain. On the afternoon of the same day, we were informed by IM resident  that the same  patient  was rushed to their department complaining of severe chest pain and eventually expired due to AF probably secondary to MI.

Insight (Discovery, Stimulus, Reinforcement):

            This particular incident teaches us to treat our patient wholistically. As a surgeon, we must be keen enough to observe other underlying medical condition.  In retrospect, if I have done ECG maybe I could have prevented his death.