1. Chest Pain - causes of chest pain Flashcards
What is the most important diagnosis to make from chest pain
Myocardial ischemia
If you can rule out chest pain then what are the main non-cardiovascular causes
upper GI
respiratory
musculoskeletal
What are the cardiac causes of chest pain that lead to myocardial ischemia
aortic stenosis hypertrophic cardiomyopathy (HOCM) Tachyarrhythmias (Vtac supra Vtac) Cocaine use anemia thyrotoxicosis
What are the cardiovascular non-ischemic causes of chest pain
aortic dissection
pericarditis
What are some upper GI causes of chest pain
GORD
Gallstones
peptic ulcer
pancreatitis
what are some respiratory causes of chest pain
pulmonary embolism
pneumothorax
pneumonia
pleurisy (inflammation of the pleural space causes by a viral infection)
What are some musculoskeletal causes of chest pain
Costochondritis (pain at junction of ribs)
herpes zoster or shingles (before the rash comes out)
SOCRATES for chest pain ;
What conditions would show the following symptoms
S: diffuse pain that is poorly localised
visceral pain that comes from internal organs
SOCRATES for chest pain ;
What conditions would show the following symptoms
S: well localised pain
somatic pain that comes from the musculoskeletal system
SOCRATES for chest pain ;
What conditions would show the following symptoms
O: sudden onset of chest pain
pulmonary embolism
SOCRATES for chest pain ;
What 2 conditions would show the following symptoms
C: pressure feels heavy and tight
acute coronary syndrome (ACS)
GORD
SOCRATES for chest pain ;
What conditions would show the following symptoms
C: indigestion/belching
ACS
GORD
SOCRATES for chest pain ;
What conditions would show the following symptoms
C: severe ripping pain
aortic dissection
SOCRATES for chest pain ;
What conditions would show the following symptoms
C: sharp, stabbing pain
pleuritic pain
musculoskeletal pain
SOCRATES for chest pain ;
What conditions would show the following symptoms
Radiation to left arm, both arms, jaw or neck
ACS
SOCRATES for chest pain ;
What conditions would show the following symptoms
radiation to right shoulder
Cholecystitis- inflammation of gallbladder and radiates to nerves of the diaphragm (gallstones)
SOCRATES for chest pain ;
What conditions would show the following symptoms
radiation to the back ie interscapular
aortic dissection GORD Pancreatitis peptic ulcer ACS
SOCRATES for chest pain ;
What conditions would show the following symptoms
Radiation to the epigastrium
Pancreatitis
peptic ulcer
gallstones
ACS
SOCRATES for chest pain ;
What conditions would show the following symptoms
Associated features: nausea and vomiting
ACS
Upper GI pathology
SOCRATES for chest pain ;
What conditions would show the following symptoms
A: sweaty, clammy
ACS
PE
aortic dissection
SOCRATES for chest pain ;
What conditions would show the following symptoms
A: SOB
ACS
respiratory causes
SOCRATES for chest pain ;
What conditions would show the following symptoms
A: hypotension/syncope (passing out)
PE
ACS
aortic stenosis
SOCRATES for chest pain ;
What conditions would show the following symptoms
Timing of seconds
musculoskeletal, non-cardiac
SOCRATES for chest pain ;
What conditions would show the following symptoms
timing of minutes
ACS
GORD
musculoskeletal
SOCRATES for chest pain ;
What conditions would show the following symptoms
timing of hours
ALL
SOCRATES for chest pain ;
What conditions would show the following symptoms
timing of days
dull persistent pain- defo not ACS
SOCRATES for chest pain ;
What conditions would show the following symptoms
E: Exertion, emotion
Angina
SOCRATES for chest pain ;
What conditions would show the following symptoms
E: Eating
ACS
GORD
peptic ulcer
SOCRATES for chest pain ;
What conditions would show the following symptoms
E:positional
pericarditis
GORD
musculoskeletal
Pancreatitis
Which condition is being described here in when describing the chest pain using SOCRATES:
R: to the back or epigastrium
E: positional change makes it worse
Pancreatitis
Which condition is being described here in when describing the chest pain using SOCRATES:
O: sudden onset
A: sweaty, clammy as well as hypotension/syncope (passing out) and SOB
Pulmonary embolism
Which condition is being described here in when describing the chest pain using SOCRATES:
Radiating pain to the right shoulder
Cholecystitis- inflammation of gallbladder and radiates to nerves of the diaphragm (gallstones)
Which condition is being described here in when describing the chest pain using SOCRATES:
C: pressuure is heavy and tight, indigestion/belching
R: Radiation to the back
E: eating and also postional changes
GORD
Which condition is being described here in when describing the chest pain using SOCRATES:
central chest pain that doesn’t radiate
E: pain on exertion or extreme emotion
angina
Which condition is being described here in when describing the chest pain using SOCRATES:
C: severe ripping pain
R: radiates to the back
Aortic dissection
Which condition is being described here in when describing the chest pain using SOCRATES:
R: radiates to either the back or epigsatrium
E: when eating
Peptic ulcer
Which condition is being described here in when describing the chest pain using SOCRATES:
C: pressure is heavy and tiight, indigestion and belching
R: left arm, both arms, jaw, neck. Also to the back and epigastrium
A: nausea, sweaty and clammy, SOB, hypotension
T: minutes
E: eating,
ACS
