Approach to Chest Pain

Question 1

What is the rifle approach to Chest Pain?

Answer 1

if you shot a bullet through the chest and it went all the way through, what could it hit and cause pain to at different levels as it travel into and out of the chest. 
Skin
Subq
MSK
Pleura
pericardium
heart
esophagus and trachea
aorta

Question 2

4 things to consider at the skin level?

Answer 2

lacerations, burns, bites, and herpes

Question 3

2 things to consider at the subq level?

Answer 3

cellulitis, abscess

Question 4

4 things to consider at the MSK level?

Answer 4

sprains, strains, fracture, costochondritis

Question 5

5 Ps to consider at the pleura level? this pain is usually pleuritc meaning with breathing.

Answer 5

pneumothroax, pneumonia, PE, pulmonary cancer, pleurisy

Question 6

1 things to consider at the pericardium level? this pain is usually positional.

Answer 6

pericarditis

Question 7

2 things to consider at the heart level?

Answer 7

MI, myositis,

Question 8

3 things to consider at the esophagus level?

Answer 8

GERD, esophagitis, perforations

Question 9

2 things to consider at the trachea level?

Answer 9

tracheitis and perforations

Question 10

2 things to consider at the aorta level?

Answer 10

dissection, aneurysm

Question 11

first 3 tests to do if someone shows up and the chief complaint is chest pain?

Answer 11

CXR
12 lead ECG
troponin

Question 12

what are the important aspects of the exam/interview for chest pain?

Answer 12

diamond classification
is the pain tender, pleuritc, positional?
do the PE

Question 13

how can we rule in/our esophagus pain?

Answer 13

swallow lidocaine and if it improves you know it touches something in the esophagus that was hurting.