Chest pain Flashcards
Ischaemic chest pain usually??
Crushing, poorly localized retrosternal pain radiating to either arm/jaw, a/w diaphoresis and dyspnea.
Aortic dissection?
Crushing retrosternal pain radiating to back between scapuale. Sudden maximal pain at onset, improves with time.
Dissection involving carotid artery region = neurological symptoms
Dissection involving subclavian artery region = radial-radial and radial-femoral delay
Retrograde spread of dissection = aortic regurg/AMI (early diastolic murmur)
Pneumothorax?
Pleuritic chest pain + possible dyspnea + possible desaturation
Lower chest expansion, hyper-resonance, lower air entry on affected side.
Tension pneumothorax can cause hypotension, medistinal shift, tracheal deviation.
Pulmonary embolism?
Classic pleuritic chest pain, dyspnea, hypoxia with normal lung exam.
Subtle presentation with unexplained hypoxia, tachycardia, tachypnea.
Massive PE may have hypotension.
Cardiac tamponade?
Chest pain + dyspnea, a/w hypotension, high JVP, pulsus paradocus, muffled heart sounds.
Esophageal rupture
Chest pain following violent vomiting or esophageal instrumentation
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Pneumonia with pleurisy?
Pleuritic chest pain with fever, cough.
May have sputum prod with dullness.
Crackles on respi exam.
CXR shows consolidation.
Pericarditis?
Pleuritic chest pain. May have pericardial friction rub.
Usu have underlying etiology. Diagnosis usu made with ECG findings.
Myocarditis
Vague varying presentations.
Typical is young healthy patient with viral prodrome and then develops chest pain.
Cholecystitis
RHC pain - constant, unremitting
Hx of fatty food before pain
Radiate to inferior angle of scapula/back
Fever, N/V, anorexia
Mild jaundice may be there
Murphy’s sign positive
Palpable GB