Chest Pain Flashcards
What systems can be associated with chest discomfort/pain?
Cardiovascular Respiratory GIT MSK Derm
Possible CVS causes of chest discomfort/pain
Angina MI Pericarditis Aortic dissection AAA
Characteristic pattern of ANGINA
Varies with STRESS/EXERCISE Tight/heavy central chest pain Radiates (arm, neck, jaw) Relieved with GTN Associated w/ SOB
Characteristic pattern of MI
DOES NOT VARY with stress/exercise; can occur at rest
NOT RELIEVED by GTN
Tight/heavy central chest pain
Radiates (arm, neck, jaw)
Associated w/ SOB AS WELL AS sweating, nausea, vomiting
Characteristic pattern of PERICARDITIS
RAW/SHARP chest pain
Worsened by LYING FLAT/RESPIRATION; eased by leaning forwards
May be associated with SOB, fever
Characteristic pattern of AORTIC DISSECTION
TEARING, INTERSCAPULAR pain Other anatomical pain distribution due to ischaemia if blood supply is compromised - CVA (cerebrovascular ischaemia) - Abdo pain (mesenteric ischaemia) - Paraplegia (spinal cord ischaemia)
Characteristic pattern of resp. pain i.e. PLEURITIC PAIN (PE, PNEUMONIA)
SHARP/STABBING pain Worsened by INSPIRATION PE: - SOB & haemoptysis Pneumonia: - Fever, productive cough
Possible causes of GIT chest discomfort/pain
GORD
Oesophageal spasm
Characteristic pattern of pain in GORD
BURNING DISCOMFORT from stomach or lower chest –> neck
Worsened by BENDING OVER, LYING DOWN, AFTER EATING
Associated with waterbrash
Characteristic pattern of pain in OESOPHAGEAL SPASM
Can mimic angina - relieved by GTN
UNRELATED TO EXERTION, can OCCUR AT REST
Possible causes of MSK chest discomfort/pain
Costochondritis
Rib #
Malignant chest wall involvement
Characteristic pattern of pain in ALL MSK CAUSES
LOCALISED chest discomfort
Worsened by MOVEMENT
May be of SUDDEN ONSET and ACUTE (last few seconds) e.g. #
May be gradual/chronic (e.g. costochondritis, Ca)
Possible causes of dermatological chest discomfort/pain & pattern of pain
SHINGLES (herpes zoster)
Usually UNILATERAL
NERVE ROOT DISTRIBUTION
BLISTERING RASH
