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CVS > 17. Chest Pain And Acute Coronary Syndromes > Flashcards

17. Chest Pain And Acute Coronary Syndromes Flashcards

1
Q

What are the 4 main areas that can cause chest pain?

A

MSK
Respiratory
Gastro-intestinal
Cardiac

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2
Q

What are the possible respiratory causes for chest pain?

A

Pneumonia

PE

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3
Q

What are the possible cardiac causes of chest pain?

A

MI
Stable/unstable angina
Pericarditis

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4
Q

What is a possible gastro-intestinal cause for chest pain?

A

Reflux

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5
Q

What are the possible MSK causes of chest pain?

A

Broken rib
Costochondritis
Pulled intercostal muscles

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6
Q

What is cardiac (ischaemic)?

A 
Visceral
Dull
Poorly localised
May radiate to shoulder or jaw 
Worsened with exertion
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7
Q

What is pleuritic pain?

A

Somatic
Sharp pain
Well localised
Worse with inspiration, coughing or positional movement

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8
Q

Which conditions can mimic pleuritic pain?

A

Conditions such as pericarditis and MSK disorders of the chest wall

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9
Q

What are the symptoms of pericarditis?

A

Present with retrosternal chest pain
Sharp, localised to front of chest
Aggravated with inspiration, coughing, lying flat
Eased with sitting up and leaning forward
Pericardial rub may be heard on auscultation

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10
Q

What is the ECG in pericarditis?

A

Widespread saddle shaped ST segment elevation

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11
Q

What are the modifiable risk factors for atherosclerosis/ischaemic heart disease?

A 
Smoking
Hypertension
Dyslipidaemia
Diabetes
Obesity
Sedentary lifestyle
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12
Q

What are the non-modifiable risk factors for atherosclerosis/ischaemic heart disease?

A

Advanced age
Family history
Male sex

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13
Q

What is the typical patient history of stable angina?

A

Only occurs on exertion
Relieved by rest
Cardiac sounding chest pain
Short-lived chest pain

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14
Q

Why does stable angina happen?

A

Heart tissue ischaemia only occurs when metabolic demands of cardiac muscle are greater than what can be delivered via coronary arteries (on exertion)
Artery narrowed due to atherosclerosis

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15
Q

What are the acute coronary syndromes?

A

Unstable angina
Non-STEMI
STEMI

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16
Q

What are acute coronary syndromes?

A

Acute myocardial ischaemia caused y atherosclerotic coronary artery disease

17
Q

What is the typical patient history of unstable angina?

A

Similar to stable angina
Except pain occurs at rest, pain may be more intense, pain may last longer
Risk of deteriorating further, may cause MI

18
Q

What are the ECG changes in unstable angina?

A

ST depression
T wave inversion
Or could be normal

19
Q

What is the typical patient history of MI?

A

Chest pain at rest
Severe
Not eating with GTN spray
Nauseous, sweating

20
Q

What are the ECG changes in non-STEMI?

A

ST segment depression
T wave inversion
Need blood test to confirm not angina

CVS (21 decks)

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