Chest Pain

Question 1

Life-Threatening

causes of

Chest Pain

Answer 1

Cardiovascular:

MI, aortic dissection, unstable angina,

acute pericarditis, myocarditis

Pulmonary/Chest:

pulmonary embolism, pneumothorax

Gastrointestinal:

esophageal rupture

Question 2

Non Life-Threatening

causes of

Chest Pain

Answer 2

Cardiovascular:

stable angina, valvular heart disease

Pulmonary/Chest:

pneumonia, thoracic outlet syndrome, mediastinitis, MSK

Gastrointestinal:

GERD, PUD, esophageal spasm, cholecystitis, pancreatitis

Heme:

sickle cell anemia

Pysch/Neuro:

anxiety, Herpes Zoster

Question 3

precipitating factors of CP

Answer 3

• exertion - inspiration - movement

Question 4

Kussmaul’s Sign

Answer 4

paradoxical filling of neck veins during inspiration - RV infarction - PE - pericarditis w/ ass’d cardiac tamponade

Question 5

New Aortic Insufficiency Murmur?

Answer 5

Aortic Dissection *remember also BP diff of 20 mmHg between UE

Question 6

New Mitral Regurgitation Murmur?

Answer 6

papillary mm dysfunction d/t ACS

Question 7

Hamman’s Sign

Answer 7

crunching sound from mediastinal air - esophageal rupture - bronchial rupture

Question 8

(4) CXR Findings of

Aortic Dissection

Answer 8

CXR Findings of Aortic Dissection:

1. widened mediastinum
2. depression of left main bronchus
3. loss of paratracheal stripe
4. > 4-5 mm separation b/n calcified intima and lateral edge of aortic knob

Question 9

(4) CXR Findings of Pulmonary Embolism

Answer 9

1. atelectasis 2. elevated diaphragm 3. Hampton’s Hump: wedge of infiltrate 4. Westermark’s sign: absence of pulmonary shadows distal to central embolism

Question 10

Hampton’s Hump + Palla’s Sign

Answer 10

Hampton’s Hump

wedge-shaped, pleural-based infiltrate representing an area of infarction

PAlla’s Sign

enlarged right descending Pulmonary Artery

Question 11

Westermark’s Sign

Answer 11

absence of pulmonary shadows distal to central embolism

Question 12