Approach to Chest Pain

Question 1

What are the 7 lethal causes of chest pain?

Answer 1

• ACS
• Aortic dissection
• Myocarditis
• Pericarditis
• PE
• Tension pneumo
• Esophageal rupture

Question 2

What is the dose of amiodarone in cardiac arrest?

Answer 2

150, then 300 mg IV

Question 3

What is the dose of adenosine in SVT?

Answer 3

6mg then 12 mg, both fast

Question 4

What amount of joules is needed for cardioversion?

Answer 4

50-100 J

Question 5

What is the first EKG change with an evolving MI?

Answer 5

Hyperacute T waves

Question 6

What is the next EKG manifestation of STEMI after ST elevation occurs? What happens after that?

Answer 6

Q wave and T wave inversion. These eventually normalize (except Q waves)

Question 7

What is Hamman’s sound in the context of esophageal rupture?

Answer 7

crackle sound heard or felt in time w/ heartbeat

Question 8

What is Beck’s triad for pericarditis?

Answer 8

• Muffled heart sounds
• Distended neck veins
• Hypotension

Question 9

What are the general s/sx of pericarditis?

Answer 9

Pleuritic chest pain with dyspnea. Classically better with leaning forward

Question 10

What are the components of the HEART score?

Answer 10

History
EKG
Age
Risk factors
Troponins

Question 11

A parent or sibling with an MI under what age is considered a risk factor for an MI?

Answer 11

UNder 65

Question 12

A BMI over what is considered a risk factor for an MI?

Answer 12

30

Question 13

Smoking cessation less than how long ago is considered a risk factor for an MI?

Answer 13

3 months