Case 1- Chest Pain

Question 1

Which four conditions make up acute coronary syndrome?

Answer 1

• stable angina
• unstable angina
• NSTEMI (non-ST elevation myocardial infarction)
• STEMI

Question 2

What is the most common cause of myocardial ischemia?

Answer 2

CAD

Question 3

What is CAD?

Answer 3

Coronary Artery Disease- the narrowing or blockage of the coronary arteries most commonly caused by atherosclerosis

Question 4

Which systems must be considered in someone presenting with chest pain?

Answer 4

• Cardiovascular
• Upper GI
• Respiratory
• Musculoskeletal

Question 5

Which cardiovascular causes of chest pain must be considered?

Answer 5

• Myocardial ischaemia (majority)
• aortic dissection
• pericarditis

Question 6

Which upper GI conditions should be considered for chest pain?

Answer 6

• GORD
• Gallstones
• Peptic ulcers
• Pancreatitis

Question 7

Which respiratory causes should be considered for chest pain?

Answer 7

• Pulmonary embolism
• Pneumothorax
• Pneumonia
• Pleurisy (inflammation of pleural space usually caused by viral infections- causes pain upon breathing)

Question 8

Which musculoskeletal causes should be considered for chest pain?

Answer 8

• Chostochondritis
• Herpes zoster or shingles (may be pain before a rash presents)
• pulled muscle from activity or trauma of some kind