By H. David Reines, MD, and Johann Jonsson, MD
A 42-year-old Somalian woman presents to the ER with pain in her left chest. She doesn’t speak English and is triaged quickly to the chest pain unit. An EKG is negative for acute changes. A troponin is drawn; when it is negative, she is sent for chest CT to rule out pulmonary emboli. The ER resident reviews the CT reading an hour later. It is negative for pulmonary emboli, but the reading mentions an 8×10-cm mass in the left breast. When