Chest pain Flashcards

1
Q

Ischaemic chest pain usually??

A

Crushing, poorly localized retrosternal pain radiating to either arm/jaw, a/w diaphoresis and dyspnea.

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1
Q

Aortic dissection?

A

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)

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2
Q

Pneumothorax?

A

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.

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3
Q

Pulmonary embolism?

A

Classic pleuritic chest pain, dyspnea, hypoxia with normal lung exam.
Subtle presentation with unexplained hypoxia, tachycardia, tachypnea.

Massive PE may have hypotension.

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4
Q

Cardiac tamponade?

A

Chest pain + dyspnea, a/w hypotension, high JVP, pulsus paradocus, muffled heart sounds.

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5
Q

Esophageal rupture

A

Chest pain following violent vomiting or esophageal instrumentation

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6
Q

Pneumonia with pleurisy?

A

Pleuritic chest pain with fever, cough.
May have sputum prod with dullness.
Crackles on respi exam.
CXR shows consolidation.

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7
Q

Pericarditis?

A

Pleuritic chest pain. May have pericardial friction rub.

Usu have underlying etiology. Diagnosis usu made with ECG findings.

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8
Q

Myocarditis

A

Vague varying presentations.
Typical is young healthy patient with viral prodrome and then develops chest pain.

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9
Q

Cholecystitis

A

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

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10
Q
A
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