Chest Pain

Question 0

What are red flags for chest pain?

Answer 0

• dizziness/ syncope
• pain in arms l>r
• pain in jaw
• thoracic back pain
• sweating
• palpitations
• dyspnoea
• pain on inspiration
• pallor
• past history: ischaemia, diabetes, hypertension

Question 1

What are life threatening causes of chest pain?

Answer 1

• acute coronary syndrome
• pulmonary embolism
• aortic dissection
• tension pneumothorax

Question 2

What diseases should you consider in chest pain + syncope?

Answer 2

AMI, PE, dissection aneurysm

Question 3

What diseases should you consider in pleuritic chest pain?

Answer 3

Pleuritic, pericarditis, pneumothorax, chest wall pain

Question 4

What diseases should you consider in chest pain + thoracic back pain?

Answer 4

Spinal dysfunction, ACS, aortic dissection, pericarditis, GIT disorders eg peptic ulcer, biliary colic/ cholecystitis, oesophageal spasm

Question 5

What differentiate AMI pain from pericarditis ?

Answer 5

Radiation in AMI

Question 6

What is the characteristic pain in aortic dissection?

Answer 6

sudden, severe, midline pain, tearing, retrosternal, radiates to abdo, flank and legs, unequal pulses

Question 7

What is the characteristic presentation of PE?

Answer 7

ECG rbbb, right axis deviation, right ventricular strain, tachycardia, dyspnoea, +/- syncope. Pulmonary infarct in 10% of PE- pleuritic chest pain + haemoptysis