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IM > Acute Chest Discomfort > Flashcards

Acute Chest Discomfort Flashcards

1
Q

Stable Angina

A

Precipitated by exertion, cold or stress

2-10 min

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2
Q

Unstable Angina

A

Increasing pattern or at rest

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3
Q

Myocardial Infarction

A

> 30 mins

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4
Q

Quality of pain in M.I

A

pressure, tightness, squeezing, heaviness, burning

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5
Q

Location of pain in M.I

A

retrosternal

radiation - neck, jaw, shoulders or arms

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6
Q

Associated features of M.I

A

S4 gallop or mitral regurgitation during pain

S3 or rales if severe ischemia

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7
Q

Pericarditis

A

variable; hrs - days; may be episodic

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8
Q

Quality of pain in pericarditis

A

pleuritic, sharp

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9
Q

Location of pain in pericarditis

A

retrosternal or toward the cardiac apex

radiation - L shoulder

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10
Q

Associated features of pericarditis

A

relieved by sitting up and leaning forward

pericardial friction rub

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11
Q

Acute Aortic Syndrome

A

sudden onset of unrelenting pain

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12
Q

Quality of pain in Acute Aortic Syndrome

A

tearing or ripping; knifelike

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13
Q

Location of pain in Acute Aortic Syndrome

A

anterior chest

radiation - back b/w shoulder blades

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14
Q

Associated features of Acute Aortic Syndrome

A

hypertension
underlying CT disorder
murmur (aortic insufficiency)
loss of peripheral pulses

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15
Q

Pulmonary Embolism

A

sudden onset

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16
Q

Quality of pain in Pulmonary Embolism

A

pleuritic

heaviness (massive PE)

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17
Q

Location of pain in Pulmonary Embolism

A

lateral (on the side of the embolism)

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18
Q

Associated features of Pulmonary Embolism

A

dyspnea, tachypnea, tachycardia and hypotension

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19
Q

Pulmonary Hypertension

A

variable (often exertional)

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20
Q

Quality of pain in Pulmonary Hypertension

A

pressure

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21
Q

Location of pain in Pulmonary Hypertension

A

substernal

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22
Q

Associated features of Pulmonary Hypertension

A

dyspnea, signs of increased venous pressure

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23
Q

Pneumonia or Pleuritis

A

variable

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24
Q

Quality of pain in Pneumonia or Pleuritis

A

pleuritic

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25
Q

Location of pain in Pneumonia or Pleuritis

A

unilateral (localized)

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26
Q

Associated features of Pneumonia or Pleuritis

A 
dyspnea
cough
fever
rales
occasional rub
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27
Q

Spontaneous Pneumothorax

A

sudden onset

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28
Q

Quality of pain in Spontaneous Pneumothorax

A

pleuritic

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29
Q

Location of pain in Spontaneous Pneumothorax

A

lateral to side of pneumothorax

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30
Q

Associated features of Spontaneous Pneumothorax

A

dyspnea

decreased breath sounds on side of pneumothorax

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31
Q

Esophageal reflux

A

10-60 min

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32
Q

Quality of pain in Esophageal reflux

A

burning

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33
Q

Location of pain in Esophageal reflux

A

substernal, epigastric

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34
Q

Associated features of Esophageal reflux

A

worsened by postprandial recumbency

relieved by antacids

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35
Q

Esophageal spasm

A

2-30 min

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36
Q

Quality of pain in Esophageal spasm

A

pressure, tightness, burning

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37
Q

Location of pain Esophageal spasm

A

retrosternal

38
Q

Associated features of Esophageal spasm

A

mimic angina

39
Q

Peptic Ulcer

A

prolonged

60 - 90 mins after meals

40
Q

Quality of pain in Peptic Ulcer

41
Q

Location of pain in Peptic Ulcer

A

epigastric, substernal

42
Q

Associated features of Peptic Ulcer

A

relieved w/ food or antacids

43
Q

Gallbladder disease

44
Q

Quality of pain in Gallbladder disease

A

aching or colicky

45
Q

Location of pain in Gallbladder disease

A

epigastric, RUQ

radiation: sometimes to the back

46
Q

Associated features of Gallbladder disease

A

pain may follow meal

47
Q

Costochondritis

48
Q

Quality of pain in Costochondritis

49
Q

Location of pain in Costochondritis

50
Q

Associated features of Costochondritis

A

swollen, tender, warm over joint

may be reproduced by
localized pressure on examination

51
Q

Cervical disk disease

A

variable; may be sudden

52
Q

Quality of pain in cervical disk disease

A

aching; numbness

53
Q

Location of pain in cervical disk disease

A

arms and shoulders

54
Q

Associated features of cervical disk disease

A

exacerbated by movement of neck

55
Q

Trauma or strain

56
Q

Quality of pain in trauma or strain

57
Q

Location of pain in trauma or strain

A

localized to area of strain

58
Q

Associated features of trauma or strain

A

reproduced by movement or palpation

59
Q

Herpes zoster

60
Q

Quality of pain in Herpes zoster

A

sharp or burning

61
Q

Location of pain in Herpes zoster

A

dermatomal distribution

62
Q

Associated features of Herpes zoster

A

vesicular rash

63
Q

Acute, potentially life threatening condition that warrants urgent evaluation and management

A

Unstable IHD
Aortic dissection
Pneumothorax
Pulmonary embolism

64
Q

Chronic condition –> serious complication

A

aortic stenosis
stable angina
pulmonary hypertension

65
Q

Acute conditions that need treatment

A

pericarditis
pneumonia/pleuritis
Herpes zoster

66
Q

Retrosternal pain

A

MI
pericarditis
esophageal spasm

emotional and psychiatric conditions

67
Q

Substernal pain

A

pulmonary HPN

esophageal reflux

68
Q

Epigastric pain

A

peptic ulcer
gallbladder disease
esophageal reflux

69
Q

Lateral

A

pulmonary embolism

spontaneous pneumothorax

70
Q

Variable onset of pain

A 
pericarditis
pulmonary hypertension
pneumonia or pleuritis
costochondritis
emotional or psychiatric conditions
71
Q

Sudden onset of pain

A

acute aortic syndrome
pulmonary embolism
spontaneous pneumothorax

72
Q

Pleuritic

A

pericarditis
pulmonary embolism
pneumonia or pleuritis
spontaneous pneumothorax

73
Q

Burning

A

esophageal reflux
peptic ulcer
herpes zoster (sharp or burning)
esophageal spasm (pressure, tightness, burning)

74
Q

Aching

A

gallbladder disease (aching and colicky)
costochondritis
cervical disk disease
trauma or strain

75
Q

Gradual atherosclerotic narrowing of coronary arteries

A

Stable IHD

76
Q

Ischemic episodes that are precipitated by increase in oxygen demand during physical exertion and relieved upon resting

A

stable angina

77
Q

Presence or absence of detectable myocardial injury and presence or absence of ST segment elevation

A

unstable IHD

78
Q

No detectable MI

A

unstable angina

79
Q

With evidence of myocardial necrosis

A

non ST elevation

80
Q

Coronary thrombus is acutely and completely occlusive, transmural MI w/ ST segment elevation and myocardial necrosis

81
Q

Encompasses unstable angina, NSTEMI and STEMI and reserved for ischemia precipitated by acute coronary atherothrombosis

A

acute coronary syndrome

82
Q

The MC cause of nontraumatic chest discomfort

A

GI conditions

83
Q

Tietze’s syndrome

A

Costochondritis causing tenderness of the costochondral junctions

84
Q

Chest x-ray - Widening of mediastinum

A

Aortic Dissection

85
Q

Chest x-ray - Hampton’s hump or Westermark’s sign

A

Pulmonary Embolism

86
Q

Chest x-ray - Chronic Pericarditis

A

pericardial calcification

87
Q

The preferred biomarker for the diagnosis of AMI

A

cardiac troponin

88
Q

Aid in exclusion of pulmonary embolism

89
Q

HEART Score

A 
History
ECG
Age
Risk Factors
Troponin (serial)

low risk - 0-3
high risk - >4

90
Q

Sensitive technique for detection of obstructive coronary disease esp in the proximal third of the major epicardial coronary arteries

A

Coronary CT angiography

IM (66 decks)

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