Impact of COVID-19 pandemic on the clinical reasoning of the physicians

Abstract

We report the case of a 65-year old patient who was admitted to the intensive care unit for acute respiratory distress. Following a large Mother’s Day meal the day before, she had recurrent episodes of vomiting, one which was followed by intense retrosternal pain with progressively worsening dyspnea.

The patient was admitted to the intensive care unit with initial suspicion of acute respiratory failure secondary to an SARS-CoV-2 infection. However, following the integration of the anamnesis into the patient's clinical state, the diagnosis of Boerhaave's syndrome is immediately suggested.

The aim of this article is to try to understand, through this typical clinical case of Boerhaave's syndrome, how this health crisis can influence the clinical reasoning of caregivers.

Keywords: Boerhaave syndrome, cognitive bias, clinical reasoning, COVID-19, SARS-CoV-2