Chest pain Flashcards
Likelihood of a symptom leading to a consultation
Reduced energy 456:1
Headache 184:1
Disturbance of gastric function 109:1
Backache 52:1
Pain in chest 14:1
Chest pain is common
5% population experience chest pain in any two week period
2% patients in GP have chest pain as new symptom
30% hospital medical admissions have chest pain
Sources of chest pain
Cardiac Pericardial Oesophageal Pleural Vascular Musculoskeletal Neurological Psychological
Acute life threatening causes of chest pain
Myocardial ischeamia/ infarction
Massive PE
Ruptured aortic aneurysm
Pericarditis
Acute pneumothorax
Ruptured oesophagus
Angina pectoris
Medical term for chest pain
Similarities of MI and angina
Pain distribution
Differences of MI and angina
Severity
Frightening
Lasts hours
Not relieved by nitrates
Not precipitating cause
Accompanied by pallor, sweating, vomiting
Cardiac pain location
Front of chest, mid or upper sternum
Radiates to left arm, both arms, round the chest or into the jaw
Description of chest pain
Tight, heavy, constricting, crushing, numbing or burning
Atypical chest pain
e.g. in women and diabetes
Chest pain history
Onset
Site of pain
Quality and intensity
Pattern and duration
Exacerbating factors
Associated symptoms
Relieving factors
Check list for stable angina
- predictable
- related to exercise
- worse in cold or windy weather
- induced by stress
- relieved by nitrates
Suspected MI treatment (community)
Aspirin
GTN spray
Diamorphine
O2 (if sats <96%)
Pericardial pain
Mediastinal pain
May be referred to shoulder and back
Made worse by breathing, coughing and sneezing
Influenced by posture, typically relieved by sitting forward
Causes of pericarditis
Viral infection
- in context of ‘flue like’ illness
- coxsackie virus, mumps, herpes, HIV
Post MI
