Dr. Narendra Kumar (Internal Medicine) needs a second opinion on this medical case.
A 45 y/o male presents with severe left-sided chest pain which is radiating to the shoulder. He had 1 episode of vomiting when the pain started. The pain started when he was doing cardio in the gym.
No past medical or surgical history. No family history of heart disease.
He is nonsmoker but drinks alcohol on alternative day.
Vitals are wnl
Chest xray shows Left-sided pneumothorax and pleural effusion
Hb: 15.8 g/dL
Sodium: 143 mmol/L
Potassium: 3.6 mmol/L
Chloride: 105 mmol/L
Bicarbonate: 25 mmol/L
Blood Urea Nitrogen:19 mg/dL
Creatinine: 1.8 mg/dl
Total bilirubin: 1.4 mg/dL
Albumin: 4.8 g/dL
What are your views on management?