Chest Pain

Question 1

What are the main causes of chest pain?

Answer 1

Cardiac
Pulmonary
Gastro-oesophageal
Musculoskeletal

Question 2

Describe the chest pain associated with an Myocardial Ischaemia

Answer 2

Crushing/gripping pain
Retrosternal –> Neck, shoulder, jaw, teeth, back, abdo
Associated w/ paraesthesia/heaviness in 1/2 arms, dyspnoea, nausea, sweating
Provoked by exercise
Relieved by rest
Comes on over minutes

Question 3

Describe the chest pain associated with an Aortic Dissection

Answer 3

Tearing/ripping, severe, central pain
Interscapular/retrosternal --> Back, arms
Shocked pt
Neurological sx
Absent peripheral pulses
Comes on over seconds

Question 4

What does shoulder tip pain suggest?

Answer 4

Diaphragmatic pleural irritation

Question 5

Describe the chest pain associated with Pleuritic Disease

Answer 5

Localised sharp pain
Worse on deep breathing/coughing
Costochondral tenderness

Question 6

Describe the chest pain associated with Gastro-oesophageal Disease

Answer 6

Retrosternal chest pain
Worse on bending over/lying down
Relieved by antacids

Question 7

Describe the chest pain associated with Musculoskeletal Disease

Answer 7

Localised
Pain on specific postures/activities
Diagnose by palpation/local anaesthesia

Question 8

What factors make a cardiac cause of chest pain unlikely?

Answer 8

Stabbing/shooting pains
<30 seconds
Well localised, left, sub-mammary pain
Varying location
Youth