Approach to Chest Pain

Question 1

3 mechanisms of chest pain?

Answer 1

1. cardiac muscle ischaemia
2. pericardial inflamm
3. pleural inflamm

Question 2

4 structures that cause chest pain

Answer 2

aortic dissection
oesophageal irritation
muscle/bone/joint
skin inflamm

Question 3

cause of skin chest pain?

Answer 3

herpes zoster

Question 4

what pain makes MI more likely?

Answer 4

radiates to shoulder
worse on exertion
dyspnoea

Question 5

atypical pain more often in men or women?

Answer 5

Women

Question 6

who has ‘silent’ ischaemia or infarction?

Answer 6

diabetics

Question 7

where is pericarditis?

Answer 7

central or left side

Question 8

pericarditis pain described as?

Answer 8

sharps

tabbing

Question 9

pericarditis is worse on 2 things:

Answer 9

movement

breathing

Question 10

describe pleuritic pain:

Answer 10

sharp
stabbingl
ocalise

Question 11

when is pleuritic pain aggravated?

Answer 11

inspiration

cough

Question 12

can GTN help oesophageal pain?

Answer 12

relieves spasm

Question 13

what examination finding in pericarditis?

Answer 13

pericardial rub

Question 14

what examination finding in pleurisy?

Answer 14

pleural rub

Question 15

CK and troponins usually take how long to increase?

Answer 15

~6 hours