Chest pain Flashcards
Chest pain is an iceberg disease. State some sources of chest pain.
Cardiac Pericardial Oesophageal Pleural Vascular Musculoskeletal Neurological Psychological
State 6 life threatening causes of chest pain
- Ruptured oesophagus (RARE)
- Myocardial infarction/ ischaemia
- Ruptured aortic aneurysm
- Pericarditis
- Massive PE
- Acute pneumothorax
What are the similarities and differences between an MI and angina?
Similarities: pain distribution
Differences: severity, duration, response to nitrates, accompanied symptoms (pallor, sweating, vomiting)
Outline the checklist for stabile angina
- Predictable
- Related to exercise
- Worse in cold/wind
- Induced by stress
- Relieved by nitrates
Which investigations must you always check ?
Resp rate Temp O2 sats Pulse BP
Treatment for suspected MI
M- morphine/diamorphine
O- oxygen (maintain >96%)
N- nitrate spray (GTN)
A-aspirin
Describe pericardial pain
Mediastinal pain may be refereed to shoulder/back
Aggrevated by breathing, coughing, sneezing
Influenced by posture, typically relieved by sitting forward
Causes: pericarditis, viral infection, post MI
Describe pleuritic pain
One sided, severe Aggrevated by inspiration Sharp/stabbing Dyspnoea/haemoptysis Causes: malignancy, pneumothorax, PE, pneumonia
Describe a dissecting aortic aneurysm
Difficult to diagnose/ asymptomatic
SURGICAL EMERGENCY
Pain differs to MI: more sudden onset, tearing, moves posteriorly as it tears
Suggest some less urgent causes of chest pain
Psychological Malignancy Trauma Dermatological - shingles Musculoskeletal- Tietzes' syndrome Gastro -oesophageal reflux disease (induced by bending, burning, acid taste)
