Assessment and Management of Chest Pain

Question 1

Assessment

Answer 1

• a thorough health history and physical examination, including assessment of vital signs, heart and lung sounds, and any other relevant symptoms or medical history
• assess the patient’s chest pain by obtaining a detailed history, including the onset, duration, location, and quality of the pain
• assess for any associated symptoms such as shortness of breath, nausea, or sweating.
• assess the patient’s vital signs
• perform a physical examination
  obtain ECG to help diagnose the cause of the chest pain
• blood tests to evaluate for cardiac markers, such as troponin, which can indicate damage to the heart muscle
• imaging studies, such as chest X-ray or computed tomography (CT) scan, to evaluate for any structural abnormalities or other causes of chest pain

Question 2

Pain management

Answer 2

• assess for complications of chest pain, such as myocardial infarction or heart failure and take appropriate action to prevent or manage these complications
• administering oxygen therapy to help increase oxygen supply to the body’s tissues and reduce chest pain
• administer analgesics, such as acetaminophen or opioids to help alleviate the patient’s chest pain
  positioning the patient in a comfortable position that helps to reduce chest pain, such as sitting upright or leaning forward
• monitoring vital signs to detect any changes that may indicate a worsening condition
  administer medications to help manage the patient’s chest pain, such as nitroglycerin to help dilate blood vessels and improve blood flow to the heart

troponin levels

Question 3

oxygen therapy

Answer 3

administer supplemental oxygen as needed to maintain oxygen saturation above 90%

Question 4

medications

Answer 4

medications such as nitroglycerin to help dilate blood vessels and improve blood flow to the heart

Question 5

monitoring

Answer 5

• monitor vital signs
• ECG
• other physiological parameters to detect any changes in the patient’s condition and to identify any potential complications

Question 6

monitoring

Answer 6

• monitor vital signs
• ## ECG

Question 7

Causes of Chest Pain

Answer 7

Cardiac causes of chest pain
- coronary artery disease
- myocardial infarction (heart attack)
- angina
- ischemia
- inflammation
- cardiovascular conditions

Non-cardiac causes of chest pain
- gastrointestinal conditions
- anxiety and panic attack
- trauma
- pulmonary embolism - blockage of an artery in the lungs

Question 8

Ischemia

Answer 8

lack of blood flow to the heart, which can be caused by narrowed or blocked coronary arteries

Question 9

inflammation

Answer 9

inflammation of the chest wall, which can be caused by a variety of conditions including costochondritis, pleurisy, or pericarditis

Question 10

trauma

Answer 10

chest pain can result from trauma to the chest, such as rib fracture or a bruised lung

Question 11

gastrointestinal conditions

Answer 11

chest pain can result from gastrointestinal issues, such as gastroesohpageal reflux disease (GERD) or peptic ulcer disease

Question 12

pulmonary embolism

Answer 12

chest pain can result from a pulmonary embolism, which occurs when a blood clot becomes lodged in the pulmonary artery

Question 13

anxiety

Answer 13

chest pain can result from anxiety or panic attacks, which can cause chest tightness, shortness of breath etc

Question 14

cardiovascular issues

Answer 14

chest pain can be caused by a variety of cardiovascular issues, such as
- angina
- myocardial infarction
- pericarditis
- aortic dissection

Question 15

antiplatelet therapy

Answer 15

administer antiplatelt therapy, such as aspirin, as appropriate for patients with suspected acute coronary syndrome

Question 16

nitroglycerin

Answer 16

administer nitroglycerin as appropriate for patients with suspected angina.
monitor the patient’s blood pressure before after administration

Question 17

thrombolytic therapy

Answer 17

administer thrombolytic therapy as appropriate for patients with suspected ST-segment elevation myocardial infarction (STEMI)

Question 18

signs and symptoms of chest pain

Answer 18

• chest pain or discomfort that may feel like pressure, squeezing, fullness, or pain
• pain or discomfort in other areas of the body, such as the arms, back, neck, jaw, or stomach
• shortness of breath, sweating, nausea, or lightheadedness
• a feeling of impending doom or anxiety
• fatigue or weakness