Chest Pain Flashcards
What’re the two types of ischaemic heart pain?
- Angina
- Myocardial pain
Exacerbating factors for angina
Symptoms are brought on by effort
What’re the three types of angina?
- Stable angina - Symptoms are only provoked by effort and relieved by rest
- Crescendo angina - The amount of effort required to provoke symptoms do not occur at rest
- Unstable angina - symptoms come on unpredictably, either with minimal exertion or at rest.
What is the cause of angina?
Angina is primarily caused by ischaemic heart disease, although it can be caused by aortic stenosis and rarely, by sebere pulmonary hypertension.
What’s the time course of pain + associated symptoms of an MI
Comes on after a few minuets.
Sweating, nausea and vomiting.
How does an MI differ from Angina?
It lasts for 20 minuets or more
Anginal pain without a definite diagnosis of MI is termed what?
Acute Coronary Syndrome
What is a syndrome?
A group of symptoms which consistently occur together, or a condition characterized by a set of associated symptoms.
What’re the characteristics of Aortic Dissection?
Abrupt (unlike an MI pain which evolves over several minuets)
‘Tearing quality’
Location of pain reflects the site of origin of the dissection and the spread of pain reflects the propogation of the dissection plane along the aorta.
Therefore, dissection of the ascending aorta starts in the anterior chest and rapidly (in less than a few minuets) moves into the neck and then the back.
Dissections originating in the aortic arch start as neck pain, and those in the descending thoracic aorta as interscapular or shoulder pain.
What is Pleuritic Pain?
A sharp chest pain
Exacerbated by respiration (especially extreme inspiration)
What’re the two types of Pleuritic Pain?
- Pleural - Localised to one side of the chest but NOT position dependent. Pleural rub maybe heard. Occurs with: Pneumonia (fever, cough, tachypnoea, cyanosis, bronchial breathing) Pulmonary Embolus (breathlessness, tachycardiac, cyanosis, no broncial breathing) Pneumothorax (absent breath sounds)
- Pericardial - Worse on deep inspiration, located in the center of the chest, position dependent (relieved by sitting forwards.) Pericarditis occurs with viral infections, post MI and autoimmune diseases
What’re the causes of Pleuritic Pain?
- Pneumonia (fever, cough, tachypnoea, cyanosis, bronchial breathing)
- Pulmonary Embolus (breathlessness, tachycardiac, cyanosis, no broncial breathing)
- Pneumothorax (absent breath sounds)
What’re the causes of Pericardial Pain?
Pericarditis occurs with:
Viral infections,
Post MI
Autoimmune diseases
What’re the characteristics of Musculoskeltal Chest Pain?
History of physical injury (not usually found)
Provoked by arm / chest movement and lasts many hours.
Movement may cause pain but rest usually does not relieve it.
Examination may show localised tenderness.
What 2 conditions cause Gastro-Oesophageal pain?
Oesophageal reflux
Oesophageal spasm
