Chest Pain

Question 1

Chest pain at night or at rest or use of illicit substances (methamphetamines, cocaine), 5-FU

Answer 1

Coronary vasospasm

Question 2

A tall, thin person with long arms with tearing acute chest and back pain

Answer 2

Marfan syndrome and aortic dissection

Question 3

A tall, thin young man who smokes with sudden pleuritic chest pain and dyspnea

Answer 3

Spontaneous pneumothorax

Question 4

A postmenopausal woman with STEMI following severe emotional/physical stress and normal coronary angiography

Answer 4

Stress-induced (takotsubo) cardiomyopathy; look for characteristic apical ballooning on ventriculogram

Question 5

Forceful vomiting followed by chest pain

Answer 5

Esophageal rupture and mediastinitis

Question 6

Chest pain during the peripartum period

Answer 6

Spontaneous coronary artery dissection

Question 7

Sharp anterior chest pain, pleuritic, worse when supine

Answer 7

Acute pericarditis

Question 8

Typical angina

Answer 8

substernal chest pain with exertion and relief with rest or nitroglycerin

Question 9

Atypical CP equivalent symptoms

Answer 9

dyspnea, fatigue, nausea, and vomiting, most commonly found in women and in patients with diabetes