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Placement > Chest Pain > Flashcards

Chest Pain Flashcards

1
Q

What are the 9 Causes of Chest Pain?

A
  1. Stable Angina
  2. STEMI/Acute Coronary Syndrome (ACS)
  3. Acute Pericarditis
  4. Gastro-Oesophageal Reflux Disease (GORD)
  5. Pleurisy/Pleuritic
  6. Cardiac Arrhythmias
  7. Delayed Onset of Muscle Soreness (DOMS)
  8. Pulmonary Embolism
  9. Heart Failure
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2
Q

What is Stable Angina?

A

Cardiac pain brought on by physical excretion and relieved in rested state. Caused by plaque build up in arterial walls, restricting blood flow. Can’t enough O2 to cells making ischaemic tissue causing pain.

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3
Q

Signs and Symptoms of Stable Angina

A
  • Dull ache, heavy or crushing
  • Relieves at resting
  • Associated w/ SOB, nausea, vomiting, pale, clammy, sweaty
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4
Q

Clinical Findings for Stable Angina

A
  • Normal ECG
  • ECG may show pathological Q waves
  • If ST changes present consider ACS
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5
Q

What is a STEMI?

A

STEMI (ST-elevated myocardial infarction) occurs when there is an occlusion of an artery in the heart. Occlusion is formed by plaque build up, reducing blood flow to heart tissue. The tissue dies due to becoming slightly ischaemic.

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6
Q

What is Acute Coronary Syndrome (ACS)?

A

Acute Coronary Syndrome (ACS) refers to non ST elevated myocardial infarction or unstable angina (NSTEMI). Identified by ST depression and/or inverted T waves

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7
Q

Signs & Symptoms of STEMI/ACS

A
  • Onset at rest
  • No exacerbating/relieving factors
  • Associated with SOB , nausea, vomiting, pale, clammy, sweat y
  • Radiates into jaw, arms and upper back
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8
Q

Clinical Findings of STEMI/ACS

A
  • ST elevation with reciprocal changes (STEMI)
  • ST depression (ACS)
  • Inverted T waves (ACS)
  • Left Bundle Branch Block (LBBB) new onset
  • LBBB syarbossa criteria met
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9
Q

What is Acute Pericarditis?

A

Inflammation and irritation to the pericardium (heart sac). The layers rub against one another causing pain

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10
Q

Signs and Symptoms of Acute Pericarditis

A
  • Sharp or dull central or left sided chest pain
  • Sudden onset
  • Pain may radiate to left shoulder or neck
  • Pain increases when lying flat and breathing deeply
  • Pain eases when sitting upright and leaning forward
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11
Q

Clinical Findings of Acute Pericarditis

A
  • Sharp or dull central or left sided chest pain
  • Sudden onset
  • Pain may radiate to left shoulder or neck
  • Pain increases when lying flat and breathing deeply
  • Pain eases when sitting upright and leaning forward
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12
Q

Clinical Findings of Acute Pericarditis

A
  • Widespread ST elevation in I, II aVl
  • PR depression in I, II, aVL
  • ST depression in aVR and V1
  • PR elevation in a VR and V1
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13
Q

What is Gastro-Oesophageal Reflux Disease (GORD)?

A

Digestive disorder affecting lower oesophageal sphincter. Sphincter can’t close properly to prevent stomach stomach acid/food flowing back into the oesophagus

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14
Q

Signs and Symptoms GORD

A
  • Epigastric abdominal pain that radiates into chest
  • Pain is burning/sharp
  • Onset after eating
  • Pain relieved after belching
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15
Q

Clinical Findings of GORD

A
  • ECG/cardiac assessment normal
  • Obs normal
  • Chest auscultation normal
  • Epigastric abdominal tenderness
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16
Q

What is Pleurisy?

A

Condition which the two thin layers of tissue separating the lungs from the chest become inflamed, rubbing together causing pain

17
Q

Signs and Symptoms of Pleurisy

A
  • Sharp pain
  • Non-radiating
  • Exacerbated w/ movement, coughing and breathing
  • Associated w/ a cough and abnormal respiratory assessment
18
Q

Clinical Findings of Pleurisy

A
  • Normal ECG/cardiac assessment
  • Decreased air entry on auscultation due to consolidation
  • Pleural friction rub
  • Dull upon percussion
19
Q

What are Cardiac Arrhythmias?

A

When electrical conduction across the myocardium is not working in conjunction with each other. This can cause tachycardia, bradycardia, irregular heart beat

20
Q

Signs and Symptoms of Heart Arrhythmias (6)

A
  • Intermittent chest pain
  • Palpitations
  • SOB
  • Pale, clammy, sweaty
  • Dizziness
  • Syncope
21
Q

Clinical Findings of Heart Arrhythmias

A
  • ECG abnormalities
  • Tachycardia/bradycardia
  • Tachypnoea
  • Hypotension
22
Q

Delayed Onset of Muscle Soreness (DOMS)

A
23
Q

What is Delayed Onset of Muscle Soreness (DOMS)?

A

Pain and stiffness felt in muscles which develops hours/days after strenuous exercise

24
Q

Signs and Symptoms of DOMS

A
  • Global chest pain
  • Exacerbated when moving/stretching
  • Tender on palpation
  • Associated with physical activity in the days leading up to pain
25
Q

Clinical Findings of DOMS

A
  • ECG and cardiac assessment normal
  • Decreased/added chest sounds on auscultation
  • Pleural friction rub
  • Dullness on percussion
26
Q

What is a Pulmonary Embolism?

A

A Pulmonary Embolism is a blockage in one of the pulmonary arteries. In most cases, a Pulmonary Embolism is caused by blood clots that travel to the lungs from deep veins in the legs or, rarely, from veins in other parts of the body. When clots form in your lower legs, it is known as Deep Vein
Thrombosis (DVT).

27
Q

Signs and Symptoms of PE

A
  • Sudden onset of SOB
  • Sharp Chest Pain
  • Hemoptysis
28
Q

Signs and Symptoms of PE

A
  • Sudden onset of SOB
  • Sharp Chest Pain
  • Hemoptysis
29
Q

Risk Factors for PE

A
  • Recent long flight
  • recent surgery
  • Pregnancy
  • Use of contraceptive medication
  • History of immobility
  • Lower leg pain/swelling
30
Q

Clinical Findings for PE

A
  • Tachypnoea
  • Chest Auscultation normal
  • ECG: Slurred S wave in lead I, Pathological Q and inverted T wave in lead III
  • Reduced SpO2
31
Q

What is Heart Failure?

A

Heart failure is where the heart does not pump properly. Can affect the left and right side (diastole/systole). Diastolic failure means the ventricle doesn’t fill with blood properly. Systolic failure happens when the ventricles cant contract properly, preventing adequate blood supply to the body.

32
Q

Signs and Symptoms of Heart Failure

A
  • SOB worse when lying flat
  • Chest pain
  • Lower limb and lower back swelling
  • Abdominal swelling
  • Hemopytsis (blood ejected from the lungs)
33
Q

Clinical Findings of Heart Failure

A
  • Course crackles at the base of the posterior wall
  • Peripheral/ or sacral oedema
  • Ascites (fluid in the abdomen)
  • ECG showing tall R waves in I, aVL, V4-V6 and large S wave
    depth in III, aVR, V1-V3
  • Tachypnoea

Placement (9 decks)

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