Chest Pain

Question 1

What are the ‘Six Ps’ that represent the common symptoms of ischaemic limbs?

Answer 1

• pain
• pallor
• paralysis
• parasthesia
• pulseless
• perishly cold

Question 2

What are some common causes of chest pain?

Answer 2

• myocardial ischaemia
• angina (reversible myocardial ischaemia
• pleuretic pain
• trauma

Question 3

What does myocardial ischaemia mean?

Answer 3

Insufficient oxygenated blood is flowing to the heart muscle because of an imbalance of supply and demand.

Question 4

What is the most common cause of myocardial ischaemia?

Answer 4

narrowing of one or more coronary arteries due to atherosclerosis

Question 5

What is angina?

Answer 5

• reversible myocardial ischaemia

Question 6

How does angina typically present?

Answer 6

diffuse central chest pain, often radiating to the arms (usually the left) and also the neck, lower jaw and upper abdomen. It is usually described as a heavy pain or pressure.

Question 7

What is a classic precipitating factor for angina?

Answer 7

• physical exertion as it increases oxygen demand.

Question 8

What are some associated features of angina?

Answer 8

• dyspnoea
• nausea
• sweating

Question 9

What is a myocardial infarction?

Answer 9

• prolonged angina pain (>20 minutes) suggest myocardial infarction where ischaemia is so severe that is can causes permanent heart muscle damage/necrosis.

Question 10

What are some important risk factors for coronary artery disease?

Answer 10

• smoking
• high BP
• high cholesterol
• diabetes
• physical inactivity
• poor diet
• family history
  ( - age & gender)

Question 11

What are some key differences between a myocardial infarction and an angina episode?

Answer 11

• time course
• context
• relieving factors (are there any?)
• severity