Chest pain Flashcards
history taking
-SQUITARS
SQUITARS
-site/quality “(dull/sharp)/ intensity (on a scale of 1/10) / timing (how long it lasts, when incomes on?)/ Aggrevating factors/ Relieving factors/ Secondary symptoms
causes of chest pain differential diagnosis
- MSK (including skin)
- heart
- respiratory
- gastointestinal system
respiratory causes
- chest pain if problems with (PARITEAL) pleura ;
- e.g pneumonia that irritates the pleura
- pulmonary embolism (lung tissue infarcts and undergoes necrosis irritates the pleura)
presentation of reprepistaroy diseases w
- sputum
- shortness of breath
- fever
- oedema d DVT (PE)
cardiac c of chest pain
- MI
- Stable / unstable Angina
- Pericarditis
- cardiac tamponade (other things would be going on so don’t alway preset chest pain)
- iscahemia
MI vs Pericarditis pain
-P= sharp retrosternal well localised, worse on coughing and breathing in , PLEURITIC PAINbut if lung lateral and anterior of chest
MSK causes of chest pain
- rib fracture, swollen,
- when breathe and cough feel pain = PLERUTIC PAIN
- spasm of intercostal muscles
- artheritis
- costochonritis (inflammation of costal cartilage, simple AB will fix it)
what presents as pleuritic pain
-resp, card, msk
gastrointestinal c of chest pain
- gastrooesphgael reflex , but hey say its burning and running up the chest, cetian foods/ lying flat c pain
whats special about the movement with pericarditis
pericarditis easies when they lean forward
heart+coronary arteries or lung
visceral pain-
pleural sad or pericardial sack
somatic nervous system
-
visceral
- dull , poorly localised but central (cant pin point it), worsen with excursion , can radiate to jaw/shoulder
pl
-localised, worsen with moment, coughing , eased by sitting forward, worsen when in forward, sharp
pericardiatis
- more common in males, and adults
- viral history is important to ask
- parietal pain
- can hear pericardial rub wc is the after the Lub rub on top of it b heart s beating and rubbing through the inflamed pericarditis
- on ecg ; ST elevation cis widespread on all chest leads and limb leads, don’t see this in MI, also saddle shaped
noniscahmeic c of chest pain
pericarditis
ischameic c of chest pain
- involves coronary arteries
pathology of ischemic heart pain
atheroschelrosis
ateroshellrsi
fattty pique with fibrous plaque cis prone to rupture and so threat of rupture an b clot and v bf
risk factors for schema heat disease
CVD risk factos
modifiable and nonmediabfale CVD risks
- mod; smoking, obesity, diabetes, hypertension
non- age, family history, male
angina
-stable and nonstable
angina c
heart demand and supply is imbalance -
