14 Chest Pain Flashcards
60yo M presents with sudden onset of substernal heavy chest pain that has laster for 30 minutes an radiates to the left arm. The pain is accompanied by dyspnea, diaphoresis and nausea. He has a history of hypertension, hyperlipidemia and smoking.
MYOCARDIAL INFARCTION (MI) gerd angina costochondritis aortic dissection pericarditis pulmonary embolism pneumothorax
ecg CPK--MB troponinx3 cxr cbc electrolytes echocardiography cardiac catherization d-dimer helical CT
20yo African American F presents with acute onset of severe chest pain for a few hours. She has a history of sickle cell disease and multiple hospitalizations for pain and anemia management.
SICKLE CELL DISEASE - ACUTE CHEST SYNDROME pulmonary embolism pneumonia MI pneumothorax aortic dissection
cbc with reticulocyte count and peripheral smear LDH ABG D-dimer cxr CPK-MB, troponin ECG CTA-chest with IV contrast
45yo F presents with retrosternal burning sensation that occurs after heavy meals and when lying down. Her symptoms are relieved by antacids.
GERD esophagitis peptic ulcer disease esophageal spasm MI angina
ecg
barium swallow
upper endoscopy
esophageal pH monitoring
55yo M presents with retrosternal squeezing pin the toasts for 2 minutes and occurs with exercise. It is relieved by rest and is not related to food intake.
STABLE ANGINA
esophageal spasm
esophagitis
ecg CPK-MB, troponin cxr cbc electrolytes exercise stress test upper endoscopy/pH monitor cardiac catheterization
34yo F presents with retrosternal stabbing chest pain that improves when she leans forward and worsens with deep inspiration. She had a URI 1 week ago.
PERICARDITIS aortic dissection MI costochondritis gerd esophageal rupture
ecg CPK-MB, troponin cxr echocardiography cbc upper endoscopy esr
33yo F presents with stabbing chest pain that worsens with deep inspiration and is relieved by aspirin. She had a URI 1 week ago. Chest wall tenderness is noted.
COSTOCHONDRITIS pneumonia MI pulmonary embolism pericarditis pleurisy muscle strain
ECF
CPK-MB, troponin
cxr
cbc
70yo F presents with acute onset of shortness of breath at rest and pleuritic chest pain. She also presents with tachycardia, hypotension, tachypnea, and mild fever. She is recovering from hip replacement surgery.
PULMONARY EMBOLISM Pneumonia costochondritis MI chf aortic dissection
D-dimer ECG CXR ABG CPK-MB, troponin CBC electrolytes, BUN/Cr, glucose CTA-chest with IV contrast doppler U/S - legs
55yo M presents with sudden onset of severe chest pain that radiates to his back. He has a history of uncontrolled hypertension.
AORTIC DISSECTION MI pericarditis esophageal rupture esophageal spasm gerd pancreatitis fat embolism
ECG CPK-MB, troponin cxr cbc amylase, lipase CTA-chest with IV contrast transesophageal echocardiography (TEE) MRI/MRA aorta aortic angiography upper endoscopy
