8. Chest Pain & Acute Coronary Syndrome Flashcards
What are come causes of cardiac chest pain?
Ischaemic & Infarction
Pericarditis
What type of pain does pericarditis present as?
Sharp,retrosternal pain
What position tends to ease pain from pericarditis?
Eased with sitting up and leaning forward
What type of pain does ishaemia/infarction present as?
Dull, heavy retrosternal pain
Poorly localised
Radiate to jaw, neck, shoulders
May be worse on exertion
How does respiratory chest pain differ to cardiac chest pain?
Off-centre rather than central
Pneumonia and pulmonary embolism can both present with chest pain and breathlessness. How might you differentiate between the two?
Pneumonia - temperature and cough
PE - sharp, well localised pain which is worse during inspiration and coughing
What upper GI condition can present as chest pain?
Gastric reflux - worse after food, worse lying flat
Visceral pain is usually….?
Dull, poorly localised and worsened with exertion
Somatic pain from pleural/pericardial sac is usually…?
Sharp pain, well localised.
Worsened with inspiration, coughing or positional movement.
What sound can be heard upon auscultation of pericarditis?
Friction rub
What ECG changes might be visible in pericarditis?
ST elevation
What is the pathophysiology of stable angina?
Coronary artery lumen narrowed by athosclerotic plaque, pain on exertion but no pain at rest.
What is included in acute coronary syndromes?
Unstable angina
MI
NSTEMI
STEMI
What is the pathophysiology of acute coronary syndromes?
Atheromatous plaque futures with thrombus formation causing an acute increased occlusion (in an already partially occluded lumen) leading to ischaemia.
What occurs in unstable angina?
Heart tissue ischaemia
