Cardiac Pain

Question 1

What is acute coronary syndrome?

Answer 1

A term used to describe a range of conditions associated with sudden, reduced blood flow to the heart e.g. heart attack

Question 2

What is angina?

Answer 2

Chest pain or discomfort caused when your heart muscle doesn’t get enough oxygen-rich blood.

Question 3

SOCRATES for cardiac chest pain?

Answer 3

S: Centre of chest
O: Sudden onset
C: Dull or crushing
R: Left arm, neck, jaw
A: Nausea, sweating, breathlessness
T: 10 mins - 1 hour
E: Exertion, cold air, relieved by rest, GTN spray 
S: Mild to very severe 

May sometimes present as indigestion

Question 4

What is the difference between angina and acute coronary syndrome in terms of:

1) Brought on by?
2) Relieved by?
3) Duration?
4) Severity?
5) Associated symptoms?

Answer 4

Angina:

1) Usually brought on by exertion (though unstable angina @ rest)
2) Usually relieved by rest or GTN spray
3) Short time (10-15 mins)
4) Mild-moderated severity
5) Less likely to have severe associated symptoms

Acute Coronary Syndrome:

1) Can come on at rest or exertion
2) Not relieved by rest or GTN spray
4) Lasts longer than angina symptoms
4) More severe pain
5) Associated symptoms

Question 5

What is the difference between stable angina and non-stable angina?

Answer 5

Stable angina occurs predictably. It happens when you exert yourself physically or feel considerable stress. Stable angina doesn’t typically change in frequency and it doesn’t worsen over time.

Unstable angina is chest pain that occurs at rest or with exertion or stress.

Question 6

What are the common presenting symptoms in CVS disease?

Answer 6

Dyspnoea
Oedema
Palpitations
Syncope / pre-syncope

Question 7

What can respiratory problems can cause chest pain?

Answer 7

Cough, temperature, haemoptysis, risk factors for PE

Question 8

What GI problems can cause chest pain?

Answer 8

Pain related to eating, reflux, burning, indigestion, swallowing difficulty, vomiting or regurgitation

Question 9

What musculo-skeletal problems can cause chest pain?

Answer 9

Recent falls, injury, trauma

Question 10

What psychological problems can cause chest pain?

Answer 10

Anxiety, stress, recent life events

Question 11

What are the common CVS risk factors to ask about?

Answer 11

• Diabetes
• Smoking
• Diet and exercise
• Hypertension
• Hyperlipidaemia
• Family history