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Upon their arrival in Toronto, the Western-Canadian band, with their yellow denim T-Kays, cowboy boots Coma - Violent Headache - Rare Sessions 1991-97 (CDr) hats, became an immediate curiosity in the folk-oriented, hippie clubs of the Yorkville district.

They would still where cowboy boots, but the colored T-Kay denim outfits and cowboy hats became history. Soon, Quality Records became interested in the band. By mid, The Stampeders were in the studio working on their first album. Simultaneously released on Polydor in the U. Canadian success, however, allowed the band to complete the album with Terry Brown.

The band was signed immediately and Bell rush-released the single in the U. Inat the request of their U. The Stampeders signed with U. Establishing themselves as a good concert draw in the US, The Stampeders played everywhere from New York to Hawaii, including Los Angeles, Reno, Disneyland and the much-sought-after southern-college circuit. Although it was the last record released in the U.

They were asked to represent Canada in the Rio de Janeiro Song Festival, in front of a live audience of 30, and a television audience of 90 million.

Dodson left the band in to start his own track recording studio and independent record label, Marigold. The failure of the new jazzier, funky-sounding Stampeders to gain critical and commercial acceptance, along with the increased cost of supporting the large band, eventually led to the departure of drummer, Kim Berly. Inthe original three-piece edition of the Stampeders reunited, released an album and toured as a New Country act. The trio often does annual ship cruises with their fans.

It was released in the spring of The band immegiately headed out on tour opeing for such acts as Triumph, Goddo, and Moxy among many others. The album never charted — as there were no singles pulled from it — but it did receive FM radio play helping the band promote their live shows.

Light left the band for family reasons in and was replaced by Bill Mair who would later be replaced by Wayne Brown. Starchild continued to tour across Canada, and although they never made it to Europe, their records sold well there. Heavily influenced by The Ramones, Sex Pistols and Teenage Head, the group emerged with their own unique surf and destroy sound and prankster worldview — unaffected North American suburban punk.

Ripper went solo in with a vision to pursue his passion for the acoustic guitar and roots based sound. Albums Live The El Mocambo [cassette]. He played and toured Ontario and later across Canada in the s fronting rock bands rock bands that included Phaze, Actual Size.

InStarr landed a gig as frontman for long-running Canadian club act Harbinger. The results were unsatisfactory to the band and the album was never released but did finally surface, online, in By the band went its separate ways.

In the early s he decided to step into the role of solo artist. From — he has worked from a solar powered recording studio in the woods of the Upper Ottawa Valley. Though she was playing in a band by it was a trip to New York City where a friend talked her into going on stage for an open-mic event in the East Village and received an encore that she realized she needed to pursue music.

She rapped some songs in three different languages: English, Spanish, and French. The title track to the album went No. George The Start first got together in in Toronto. Drummer Andrew St. Simon Slinger became the lead vocalist and harmonica player after he answered an ad in the Toronto Star newspaper. The Start rehearsed and recorded demos of original material in the basement of St.

After seeing one of their shows, Kim Kelly signed The Start to a management deal. Kelly also worked with other artists such as Goddo and Long John Baldry. In Capitol Records decided to put The Start in the recording studio.

The recordings were produced by Stacy Heydon and engineered by Daniel Lanois. In the summer of the band played at the Toronto outdoor festival called Heatwave.

So in Tony Blaise and Simon Slinger reformed the band as a four-piece outfit with new members Reggie Steeler on guitar and Tracy Striker on drums. The new version of The Start recorded demos and played shows in Toronto from to They played shows at the El Mocambo and Upper Lip nightclub during this period. In the band folded and the members pursued other musical interests. A second full recording of 12 songs was done the following year but these sessions were never released aside from one or two tracks appearing on later releases.

Glenn Milchem went back to Blue Rodeo full-time in The performed around Ontario until a final gig in at the Bovine Sex Club. Positive radio support by campus stations across Canada led to a tour. InMucklow left the band, leaving Starvin Hungry as a three-piece until Dave Lavoie left in formally ending the band; InMucklow started the band Half Measures.

Warren and Lavoie later joined. On the horizon is an unnamed project with Jonathan Cummins Doughboys, Bionic ; Lavoie died of colon cancer February 6, The band opened for the likes of Nickelback and Puddle of Mudd across Canada in the summer of The album had been picked up for international distribution by Universal Music overseas and when it came time to release their next album, they signed with Universal domestically.

State of Shock returned to the studio in early once again with producer Jeff Dawson for album 3. A several year hiatus found Carlucci composing and recording music for films, recruiting John Sandy Macfadyen and Garry Flint as co-writers and musicians. Following these projects, Macfadyen was commissioned to play studio sessions with Three Blue Eyes.

Flint moved on to joing National Velvet. Another nine month break found Carlucci and Duggan writing and recording with Mr. Prior to getting signed to a record deal the band toured with The Guess Who and Steppenwolf. In they moved eastward and had to establish themselves all over again on the Ontario bar circuit. They would tour as far away as South Korea but called it quits in and returned to Kamloops. He liked the band so much he signed them to his Tuesday Record label.

Regardless, they found themselves in demand as a touring act in the States. The record did go Top in Canada and subsequent successful singles followed as were international releases in England, Germany and Australia.

Their two full-length LPs managed to do well in 15 countries. They continued as a hot live attraction until at which time they called it quits. It was distributed in North America by Bullseye Records and following two Canadian tours the album managed gold sales 25, The reconfigured band did two Canadian tours over the next six months and recorded some new material in a mobile truck on the Pacific Coast leg of the second tour in with Steele on vocals, MacLeod on guitar and bass and Pat Steward Bryan Adams, The Odds on drums.

Despite strong radio support and roadwork to tour the album through the remainder of and two JUNO Award nominations in earlyChrysalis dropped the singer. MacLeod died in April of that year. Eventually, she gave up singing for work in the computer I.

He learned to play guitar, drums and piano and often jammed with locals Terry Bach and Art Bach. He was also in another act called The Rebels before moving to Vancouver after graduating high school and got a job as a draftsman with the Department of Highways. While living with his aunt and uncle. In the Fall of an old musician friend from Sicamous, Frank Babakaiff, was living in nearby Port Moody and suggested the form a band called The?

As everyone had day jobs, the band played teen dances and community halls on weekends in Burnaby and mainland Vancouver. The songs were never released. The band broke up in summer of wuth Babakaiff moved to New Zealand. In Stepp took a cruise to New Zealand to visit Babakaiff and decided to stay. The duo soon rented a house with three guys from the Okenagan Valley who had also moved to New Zealand. It was in this band that Stepp began honing his singing and songwriting skills.

Stepp played piano and guitar in the band doing mostly hits of the day, with a few Stepp original songs thrown into the mix. By he decided to move on.

It was a moderate hit in Canada in the summer of Shakedown, unfortunately, broke up by late fall that year. Stepp was left in limbo. Stepp changed management, backing band and label in the s and released his self-titled sophomore release in Canada on Vera Cruz Records. He would also create his own home studio called Dogwood Studios and began recording new material.

In the late s he was taken on by new manager Bill Crompton a songwriter who was covered by The Beatles and Cliff Richards among others. The tracks have never been released. In the s Stepp did cruise ship performances around the world. When he returned to Vancouver he played in the Chris Munday Band. Singer John Kay arrived in Toronto with his family mother and stepfather in March The family then moved to Buffalo in but John kept coming back to Toronto hanging out in Yorkville before heading to LA in He returned to Toronto in the summer of and lived in Yorkville, regularly playing the Half Beat Club.

It was then that he met up with Nick St. The Sparrow had moved from Oshawa to Toronto in late without its previous lead singer Jack London. Kay, meanwhile moved, to L. Towards that end, the singer reenlisted two old Sparrow bandmates, drummer Jerry Edmonton and keyboardist Goldy McJohn, and recruited year-old guitar prodigy Michael Monarch and bassist Rushton Moreve. Along the way, various members came and went, with bassist Moreve leaving in late ; he was initially replaced by former Sparrow member Nick St.

Nicholas, before being supplanted in early by George Biondo. It was around this time that Kay learned that two of his former bandmates were touring with a bogus Steppenwolf. Kay continues to tour with a version of Steppenwolf to this day; Goldy McJohn passed away August 1, Buddy Ackers joined in A near identical line-up Coma - Violent Headache - Rare Sessions 1991-97 (CDr) also record under the name Southern Exposure.

Guitarist Mike Heppner stayed behind and formed a new band called Priestess. The spent the next two years pounding away trying to make a name for themselves and wrote material for their next release. He re-christened them The Stitch In Tyme and the members began living in and amongst the flourishing Yorkville Village scene and within a year the band was one of the most popular acts in Toronto.

The record hit the charts and became a national hit. John Yorke moved to Sault Ste. After returning to Toronto, the band opened a coffee house called The Flick in Yorkville so that they had a place to play. In another five months, she had a recording deal as well. Stockwood spent the summer of touring and playing many festivals in Canada. With notes from Naoise Sheridan. InStoddart interviewed his uncle, British Columbia bush pilot Harold Davenport for his personal anecdotes on flying in Northern British Columbia.

Subsequently, Stoddart did the same with other British Columbia pilots from the early part of the 20 th Century. Singles Mr. Soon the duo became a trio with the addition of Atchison. They called themselves Perth Amboy and with the final addition of Webster from Vancouver and Wills from Seattle, the band became Stonebolt.

It was nearly a decade of slugging it out on the British Columbia bar scene before their career would take a turn toward stardom. Soon he landed them a recording contract with the Casablanca distributed label Parachute Records. The album featured three moderately successful singles. The band split up in Taylor, John Fraser and Ray Roper. The band split up immediately after; Larry Cohen returned to Montreal, worked on projects with Yank Barry and moved into the soundtrack business.

Her first band was a punk outfit called The Resisters that toured the very northern regions of Ontario as the bass player. Returning to Toronto, Storey met singer Karen Hendrix, an artist in development with Capitol Records, where she wrote with Karen in a per diem arrangement under Capitol executive Dean Cameron. Simon Brierley was one of the many contributing musicians to her album, and he suggested Storey as a guitarist to Andy Curran Coney Hatch, Soho 69 for his new band Coma - Violent Headache - Rare Sessions 1991-97 (CDr).

The band, at that point, consisted of Brierley, Curran and drummer Eddie Zeeman. However the acquisition of Geffen by the Universal Music Group left Caramel in search of a new identity and a new deal. Zeeman was replaced by Randy Cooke and they changed their name to Drug Plan. There was interim interest in the Drug Plan album by labels such as Interscope and Maverick, however after an extended period of time they went unsigned and subsequently disbanded.

However, the Drug Plan album was re-released in under a new band name Leisureworld. Behind the scenes, Storey continues to write and record her own music, of which many tracks can be found on her You Tube channel.

Storey remains musically active as an artist, producer and player in her sq. With notes from Virginia Storey. Her father was a saxophonist and pianist, and she first started singing in the Brandon Calvary Temple church choir at the age of three.

Her first big break came as a country singer performing at the Dauphin Country Fest in Byshe signed her first record deal with Warner Music Canada. Her eponymous debut album was released in January By Stott had reworked her image and her sound as an adult contemporary pop singer and a new record deal with EMI.

The label loved the act and the songs but not the name so it was effectively changed to Straight Lines. Bruce Allen management team sent them on the road in with another of their acts, Prism, and Klaatu across the prairies in the fall of that year. But management was unable to generate sufficient international interest and CBS dropped them resulting in Straight Lines disbanding.

Later, while writing original music together, Kromm played in the band Remote Control. While touring with Bryan Adams, Kromm gave him a demo tape of the tunes he and Arnott were working on. Adams liked what he heard and passed it on to producer Bruce Fairbairn. In Strange Advance became a 6-piece for their first Canadian tour which including two sold-out nights at Ontario Place in Toronto.

The video managed to break the Top10 on MuchMusic. The bottom finally fell out of the synth-pop market and both Current and Capitol Records passed on Strange Advance. The band changed musical direction with the addition of Wilson and DeShayes ex-Rebounds to the Blues.

Alan soon became their manager and spearheaded their first recording. When Alan left, their new manager was school teacher Lloyd Eldstrom. Finally, in the summer of they made the leap and relocated to Vancouver where the rented a house together. Within months after landing in Vancouver Wilson joined another group and Deshayes went back to school and Strange Movies was left in limbo. Another musician who had left Kelowna for the bright lights of Vancouver, Dan Ferworn, was playing in the band Times Children where Campbell and Burnett convinced him to join their band instead which would soon become a top draw power blues trio.

In they recorded two singles for Van Records which brought them to the attention of a club owner visiting from Bermuda. Soon they were flown to Hamilton, Bermuda to play at the Ace of Clubs for a season. Upon their return they played gigs in New York and Toronto followed by a second season in Bermuda.

By the fall ofthe band was left deciding what they would do next. Burnett decided to not pursue music any longer and returned to Kelowna to start a career as a horticulturist with his father; Campbell went on to play in New York and Toronto and now works as a legal assistant in Toronto; Ferworn has followed a career in the health services industry.

They would record a second album but they lacked the finances to release it and they split up in Sadly, McConnell would pass away from unknown causes on April 4, bringing an immediate end to the band. The band recorded their self-titled CD release at Presence Studio in Toronto inreleased the disc in and promptly fired the rhythm section.

Unfortunately, one arm and leg were so badly injured it took him until to fully recover and regain the confidence to return to centre stage. He attempted to reform Witness Inc. Following a year of slugging it out from their homebase in Regina, Saskatchewan to an impressive response on the Western bar circuit, Streetheart were soon signed to Atlantic Records in by Gary Muth. A personality conflict soon erupted and Dean and Frenette left in to form Loverboy. Their replacements were John Hannah guitar and Bob Ego drums.

Jeff Neill H. Kenny Shields continued to perform regularly across Western Canada as a solo act and sometimes with Streetheart until suffering a heart attack in The original line up with Paul Dean first reunited for a brief time in Inthe Streetheart reunion line-up included Jeff Neil on guitar.

Strike Force was formed in and recorded their material with French producer Ben Kaye. Paille died in September. Strike Force would split up in She met Bossin and Lewycky and they decided to form a band.

They called the label Nick Records. CTV in Toronto contacted the band to have them play on the public affairs show W5 while they interviewed Diefenbacker via satellite from Saskatoon. They flew the Stringband from Saskatoon to Toronto so they could then play for Diefenbaker back in Saskatoon!

He was amused by the song but it seemed to haunt him the remainder of his days after which he refused to comment on whether he liked it or not. Marie-Lynn Hammond went on to release a self-titled debut album in on her own independent label. Their final show was in but they did a brief reunion tour in It won seven international awards and, more importantly, played a significant role in the fight to preserve Clayoquot.

But his beginnings are as a songwriter and musician. At the age of fourteen, Stroud walked into his eighth grade music class expecting the usual boring songs. Citing many creative differences, Stroud left the band on the eve of signing what was, at the time, the largest financial advance in the Canadian history of RCA.

A few more years of writing and recording without a mentor left Stroud frustrated and turning his back on opportunities as a composer with BMG although some of his music was published along the way.

Instead, he became involved professionally in the production of rock videos and music television, where he began learning the skills of editing and camera work. At the age of twenty-five, after suffering an accident in a hockey game that broke his wrist in eight places, Stroud decided to leave music and film work altogether and focus on a life of outdoor adventure.

For the next eleven years he left music behind. InStroud, with his wife Sue, moved to Yellowknife, North West Territories, where he worked as an outdoor instructor to aboriginal special needs individuals.

One day he noticed that the local bar called itself the most northern blues bar in the world and he loved the blues. He bought a harmonica and jumped up on stage during the weekly blues jam. He eventually became the house band harmonica player, and began playing around town at the only other two venues available as a blues duo with Ridd Sorrensen. Stroud took his re-found love for music back with him to New Liskeard, Ontario where he promptly teamed up with Ian Auger and began to enter and win music festivals.

Working hard to perfect his harmonica chops, he eventually teamed up with local North Bay blues legend Jake Thomas and together they played for a year at blues festivals including the Toronto Beaches Jazz Festival and the Orillia Blues Festival. Potvin was impressed enough to look up Stroud on the web. He is currently working on a new solo release and an evening performance that highlights his award winning film-work coupled with his music. With notes from Terry Lusk and Les Stroud.

However, after touring and attempting to promote a second unsuccessful single inthe band had a line-up shuffle and became Studebaker Hawk named after a Frank Zappa character. The song managed to get to No. More frequent shows came in early on the Queen Street circuit. However, Gerry Hannah quit the band to become a political activist in the Direct Action Organization. Several members, later dubbed The Squamish Five, went on a rampage across Canada committing felonies in the name of political activism including October 14, bombing of the missile guidance system manufacturing plant owned by Litton Industries which injured several people including three Metro Toronto police officers.

Though Hannah was not part of the Litton felony, he supported it, he participated in other unlawful actions including the planning of a Brinks truck robbery. He and four other members of Direct Action were arrested in January He pled guilty to lower his jail time. He was sentenced to 10 years but only served 5.

The band released several independent singles before getting signed to Stony Plain Records for one album. The band fell apart shortly thereafter but Ruptash and Schultze carried on as a duo called Guerilla Welfare and released one album in The band added keyboardist Ken Lowry in but after continuing to struggle, major changes were soon necessary.

Carrier was replaced as vocalist in by the Murphy sisters Maureen, Aileen and Kathleen and male vocalist Geoff Marrin. Harder was replaced by MacInnes as rhythm guitarist but switched in mid to replace Mahler on bass. The group would also replace drummer Richard with consecutive players Elliott and Banman through and added keyboardist Gorling.

Enthusiastic response led to more recording and more releases. Meissner would shuttle between bass and lead vocals along with Glenn Stewart in From there they moved to Capitol Records for a full-length self-titled album in It reached No.

Harris was replaced by Sandy Crawley in They found themselves recording with a number of labels as the fervor of the British Invasion required French pop to compete at radio. Pantis let them explore their original songwriting. After a full album and several singles, Pantis started his own label and took Les Sultans with him.

In need of a new drummer Whibley convinced Steve Jocz to quit his existing band and join Kaspir. The played their first show in September under the name Supernova. By Spicoluk had been replaced by bassist Richard Roy and guitarist Dave Baksh was added so that Whibley could focus more on vocals.

By the band began recording demos and soliciting record companies. After many rejection notices Roy left the band and was soon replaced by Jay McCaslin. The line-up finally solidified and Sum 41 was officially born. The EP was certified and Gold and was encouragement enough for Aquarius Records to send the band back to the studio to complete a full album. The album would go on to receive platinum sales in North America and the UK. Simple Plan then took time off to recharge and write their next album.

The song peaked at No. The album peaked at No. The album achieved platinum certification in Canada and gold in the US. As the hostilities raged on, the U. It would go to be certified platinum in Canada and gold in the United States.

In May of Braksh quit the band to form his own solo act Brown Brigade. The band commenced recording their next album without him in November and wrapped up recording in March It debuted at No. In October the band embarked on a tour with Finger Eleven and headlined their shows with Die Mannequin opening. Limp Bizkit 23,2 mb Rap vs. Rage Against The Machine 20,8 mb Rap vs. Biohazard 19,2 mb Rap vs. Limp Bizkit 17,2 mb Rap vs. Fred Durst 26,8 mb Rap vs.

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The mainstay of treatment for costochondritis is pain relief with non-opiate analgesics. Acetaminophen and ibuprofen are appropriate treatment modalities, and the patient should be instructed to refrain from strenuous activity that reproduces symptoms.

Heating pads applied to the area also may be helpful. Patients should be informed that the pain can resolve within weeks to months, but may last up to one year. A pneumothorax occurs when free air enters the intrapleural space. It is a potential life-threatening cause of chest pain encountered in the ED.

It can be due to trauma or can occur spontaneously with or without underlying lung disease. A pneumothorax that occurs in the absence of pulmonary pathology is termed a primary pneumothorax.

This usually occur in males, smokers, those with a history of Marfan syndrome or mitral valve prolapse, and changes in ambient pressure.

Spontaneous pneumothorax occurs in approximately 15 patients perpopulation per year in males and five patients perpopulation per year in females. Patients will present with sudden-onset unilateral pleuritic chest pain and dyspnea. Sinus tachycardia is the most common physical finding.

Many primary pneumothoraces often are small in size and may not be evident on physical exam. While breath sounds classically are absent or significantly diminished with a large pneumothorax, in cases of small primary pneumothoraces, bilateral breath sounds can be present. Tracheal deviation generally is not seen, as the occurrence of a spontaneous tension pneumothorax is rare. Diagnosis is made with an upright posteroanterior chest X-ray. Measurement of the pneumothorax can be done using a variety of different techniques; for ED management purposes, the important distinction is small vs.

A small primary pneumothorax can be determined if the distance from the lung apex to the cupula is 3 cm or less on an upright chest radiograph. Patients may be observed in the ED or a traditional observation unit for four to six hours in the case of a small, minimally symptomatic pneumothorax. A repeat chest X-ray should be obtained prior to discharge to ensure that there is no increase in size.

Patients should be advised to avoid air travel and underwater diving until complete resolution of the deficit. Other options include aspiration of air with a small catheter or small chest tube placement.

ED providers are seeing an increasing number of patients with complaints of chest pain who have no risk factors for coronary artery disease and a non-diagnostic or normal evaluation. Many of these patients are found to have similar features, including life stressors, restlessness, fatigue, insomnia, and poor eating habits. Panic disorder affects more than 6 million Americans and usually develops in young adulthood. Patients who typically experience a stress reaction or panic disorder may make multiple visits to the ED for fear they are experiencing a serious cardiac event.

This is because the underlying anxiety can cause symptoms that resemble those found in acute coronary syndrome, including tingling, palpitations, and disordered breathing in addition to chest pain. In a young patient without significant medical history, no workup is required. If the patient has risk factors for acute coronary syndrome, further testing with an ECG, chest X-ray, and laboratory studies is necessary. Treatment varies, but the majority of studies support the use of conservative management with outpatient cognitive therapy.

Because the spectrum of psychological therapy can be time-consuming and progressive, its use is not practical for imitation in the ED.

With multiple sessions, cognitive therapy discussions may help the patient understand the triggers behind the attacks and how to prevent them. If calming the patient in the ED fails, medical therapy may be required. Small doses of oral benzodiazepines, such as lorazepam, diazepam, or alprazolam, can be used to alleviate anxiety. On discharge, patients should be referred to professional mental health personnel for long-term care and treatment. Cocaine users are at increased risk of myocardial ischemia because of its effects on coronary vasoconstriction, platelet aggregation, and myocardial oxygen demand.

The nature of the chest pain may vary, and no specific historical factor is more highly associated with cocaine-induced MI than an alternative diagnosis. Vital signs may be normal, but an acute rise in blood pressure commonly is seen. All patients who are evaluated for cocaine-related chest pain should have a full cardiac workup because of the increased risk of myocardial ischemia and aortic dissection.

Treatment of chest pain related to cocaine use is similar to treatment for chest pain due to atherosclerosis, with the addition of benzodiazepines such as lorazepam. The patient should be placed on cardiopulmonary monitoring, and aspirin should be given. The combination of a benzodiazepine with sublingual nitroglycerin is effective by counteracting the sympathomimetic effects of cocaine, and also may be beneficial for those with significant elevations in blood pressure.

It has been stated that providers should refrain from administering beta-blockers in cocaine-related chest pain, but this conventional wisdom is controversial. Theoretically, beta-blockade can worsen myocardial tissue damage by allowing unopposed alpha-receptor stimulation. A randomized study published in in which beta-blockers and calcium channel blockers were given to patients with cocaine-related chest pain found that there were no significant adverse outcomes.

In patients with cocaine-related chest pain who have evidence of ischemia on ECG and who do not show improvement on repeat ECG after medical therapy, percutaneous coronary intervention is warranted and is considered superior to fibrinolytic therapy. Several novel approaches have emerged in the literature for additional approaches when treating cocaine-related chest pain.

Phentolamine administration has been shown to decrease pain and coronary vasoconstriction, but further studies are needed to validate its effectiveness.

Pulmonary embolism PE occurs when a thrombus occludes a specific site in the pulmonary vasculature. Most pulmonary emboli stem from a deep venous thrombosis of the extremities or inferior vena cava. Pulmonary emboli occur when a venous clot in the periphery dislodges and travels through the right side of the heart into the pulmonary circulation. Patients who are predisposed to developing venous thromboembolisms include women taking oral contraceptives containing estrogen because of their procoagulant effect.

Patients with prolonged immobility, such as those who recently have undergone surgery or extended travel, are at an increased risk. Other risk factors include pregnancy, malignancy, trauma, and obesity. The most common symptom in patients with PE is shortness of breath, followed by chest pain often pleuritic in character and cough sometimes with hemoptysis.

Pulmonary embolism can present similarly to pleurisy, in which the patient experiences pain with deep inspiration. This may occur after an upper respiratory infection that causes inflammation of the parietal pleura. Providers must be aware that vital signs may be completely normal in young, healthy patients who present with shortness of breath and a history concerning for PE.

No specific abnormality may be seen, but the ECG can demonstrate sinus tachycardia or nonspecific ST- and T-wave changes.

The evaluation of a patient for PE has undergone extensive study in the past 20 years with the development of risk stratification and diagnostic decision-making tools. The first step is to risk-stratify the patient using one of several tools. The most studied tools are the Wells and Geneva scores. See Tables 4 and 5. If the patient is considered to be of low risk for pulmonary embolism by either tool or by clinical gestalt, then the two approaches are of equal efficacy.

The first approach is to apply the PERC criteria to determine if the potential of PE is so low as to render further testing unnecessary.


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