Application of osteopathic manipulative treatment to a patient with unremitting chest pain and shortness of breath undergoing “Rule-Out Myocardial Infarction” protocol for one week

Chest pain and shortness of breath are both common complaints of patients presenting to an emergency room (ER) or urgent care facility. A 67-year-old married white female was seen in the ER complaining of chest pain and shortness of breath. Our education and training has us admit these patients where they may be monitored and assessed according to protocols developed to rule-out serious etiologies. Accordingly, the patient was admitted to the cardiac care unit and placed on the “Rule-Out Myocardial Infarction” protocol. The patient’s symptoms persisted despite adherence to rigorous diagnostic and therapeutic regimens and which stymied attempts to arrive at a definitive diagnosis and provide care. The case presented here demonstrates how an osteopathic approach can enable us to provide appropriate care and resolve some problems that appear to be otherwise unremitting. There is potential for savings in terms of actual costs and utilization of resources. The use of an osteopathic structural exam identified an abnormality that could be easily treated with Osteopathic Manipulative Treatment (OMT), which completely resolved the patient’s presenting complaints. Had this been done earlier in the course of managing this patient, preferably as part of the admission work-up, the patient’s confinement would have been drastically reduced, and repeated expensive tests would not have had to have been performed. The application of OMT to reducing patient morbidity is instructive of the efficacy of the osteopathic approach in this case and suggests that further research is warranted.