ACS

Question 1

How CP works

Answer 1

Visceral pain from vessels or organs
Afferent sensations enter the spinal cord from multiple levels
Poorly localized: chest, arm, back, neck, jaw
Poorly described: ache, heavy, tight, burn, pain

Question 2

Heart causes of CP

Answer 2

Acute coronary syndrome

Pericarditis

Question 3

Lung causes of CP

Answer 3

Pleurisy
PE
Pneumothorax
Pneumonia

Question 4

Vessel causes of CP

Answer 4

Aortic dissection

Aortic aneurysm

Question 5

GI causes of CP

Answer 5

GERD
Esophageal rupture
Gallbladder

Question 6

Connective tissue issues of CP

Answer 6

Costochondritis
Fibromyalgia
Wall structures

Question 7

Skin causes of CP

Answer 7

Herpes zoster

Question 8

Strategy for CP

Answer 8

Differential mainly based on hx
PE helps
Tests are to prove or reinforce findings from the hx and physical

Question 9

Possible angina equivalents for CP

Answer 9

SOB
Weak
Poor sleep
Reduced exercise capacity

Question 10

Visceral etiology of CP

Answer 10

Due to lack of oxygen to myocytes

Question 11

When are CP sx less likely d/t ischemia?

Answer 11

Lasting few minutes or over 24 hrs

Pleuritic or positional pain

Question 12

Acute coronary syndrome

Answer 12

Sudden imbalance between myocardial oxygen consumption and demand, usually due to coronary artery occlusion

Question 13

Other causes of supply/demand imbalance

Answer 13

Vasospastic angina
Coronary embolism, arteritis
Noncoronary causes: hypotension, anemia, HTN, tachycardia, aortic stenosis, severe heart failure

Question 14

When should an EKG be performed?

Answer 14

Within 10 minutes of pt’s arrival at an emergency facility

May show ST elevation, ST depression, T wave changes, may be nl