Chest pain Flashcards
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causes of chest pain
MI
aortic dissection
pneumothorax
young females on oral contraceptive are more likely to suffer from what causes of chest pain?
pulmonary embolism
describe the natural of angina pain
radiates to the arms, neck and jaw
retrosternal pain
describe the natural of pulmonary embolism
SOB
coughing
haemoptysis
travel
sugery
oral comtraceptive pill
describe the natural of musculoskeletal pain
worse on inspiriation
localised
tenderness on examination
onset of chest pain 2 examples?
sudden: pneumothorax
slow, insidious: angina
character of chest pain?
retrosternal: ischaemic event
sharp tearing pain: aortic dissection
burning sensation: GI origin, GORD
radiation of chest pain?
ischaemic: to the left arm, neck , jaw
GORD: from epigastric to the throat
aortic aneurysm: radiating to the back, between shoulder blades–> immediate management
associated symptoms?
MI: cold, nauseous, sweaty with pain
chest infection: fever, productive cough
panic attack: tightness of chest, palpitation, SOB
Timing?
angina: retrosternal chest pain that occurs during excerise
ACS: pain occurring during rest, immediate medical attention
exacerbation and relieving factors
pulmonary embolism, pneumothorax, pneumonia:
chest pain worse on inspiration, pleuritic in nature
Musculoskeletal: like pleuritic pain but localised and has an area of tenderness exacerbated by movement
Pericarditis: associated with movement (notleaning forward, lying down), intensified on inspiriation,
Angina (eases with GTN): pain worse after a heavy meal, excerise, stress, emotional state, cold weather
GORD: exacerbated by hunger, lying down, relieved after alkaline substences (antacids)
facts associated with aortic dissection
sudden onset, radiating to the back, associated with hypertention, connective tissue disorder, vasculitis,
Marfan’s
facts associated with reflux disease
pain in epigastrium radiating to the throat
associated with foods: chilli, caffiene. fatty foods
excessive saliva (water brash)
sour taste (acid brash)
risk factors for ischaemic heart disease
ABCDEF’s
A: age B: blood pressure C: cholestrol D: Diabetes E: excerise F: family history S; smoking
atrial fibrilliation
risk factors for pulmonary embolism
deep vein thrombosis immobility prolonged bed rest recent surgery cancer pregnancy oestrogen supplement (contreceptive pill) smoking obesity AF hypercoagulability disorders (thrombophilia)
