Chest pain

Question 1

history taking

Answer 1

-SQUITARS

Question 2

SQUITARS

Answer 2

-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

Question 3

causes of chest pain differential diagnosis

Answer 3

• MSK (including skin)
• heart
• respiratory
• gastointestinal system

Question 4

respiratory causes

Answer 4

• 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)

Question 5

presentation of reprepistaroy diseases w

Answer 5

• sputum
• shortness of breath
• fever
• oedema d DVT (PE)

Question 6

cardiac c of chest pain

Answer 6

• MI
• Stable / unstable Angina
• Pericarditis
• cardiac tamponade (other things would be going on so don’t alway preset chest pain)
• iscahemia

Question 7

MI vs Pericarditis pain

Answer 7

-P= sharp retrosternal well localised, worse on coughing and breathing in , PLEURITIC PAINbut if lung lateral and anterior of chest

Question 8

MSK causes of chest pain

Answer 8

• 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)

Question 9

what presents as pleuritic pain

Answer 9

-resp, card, msk

Question 10

gastrointestinal c of chest pain

Answer 10

• gastrooesphgael reflex , but hey say its burning and running up the chest, cetian foods/ lying flat c pain

Question 11

whats special about the movement with pericarditis

Answer 11

pericarditis easies when they lean forward

Question 12

heart+coronary arteries or lung

Answer 12

visceral pain-

Question 13

pleural sad or pericardial sack

Answer 13

somatic nervous system

-

Question 14

visceral

Answer 14

• dull , poorly localised but central (cant pin point it), worsen with excursion , can radiate to jaw/shoulder

Question 15

pl

Answer 15

-localised, worsen with moment, coughing , eased by sitting forward, worsen when in forward, sharp

Question 16

pericardiatis

Answer 16

• 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

Question 17

noniscahmeic c of chest pain

Answer 17

pericarditis

Question 18

ischameic c of chest pain

Answer 18

• involves coronary arteries

Question 19

pathology of ischemic heart pain

Answer 19

atheroschelrosis

Question 20

ateroshellrsi

Answer 20

fattty pique with fibrous plaque cis prone to rupture and so threat of rupture an b clot and v bf

Question 21

risk factors for schema heat disease

Answer 21

CVD risk factos

Question 22

modifiable and nonmediabfale CVD risks

Answer 22

• mod; smoking, obesity, diabetes, hypertension

non- age, family history, male

Question 23

angina

Answer 23

-stable and nonstable

Question 24

angina c

Answer 24

heart demand and supply is imbalance -

Question 25

if rest elevates the chest pain

Answer 25

stable angina

Question 26

acute coronary syndrome

Answer 26

-unstable angina or MI presents with STEMI/Nstemi

Question 27

aCS

Answer 27

• c artheroschleoritc coronary artery disease
• the thrombus plaque may rupture, thumbs formation ,this c further occlusion.c worsening ischameia at rest or infarction

Question 28

what determines if patient has unstable or stable angina?

Answer 28

-degree of occlusion

Question 29

with Stemi/Nstemi what should you measure

Answer 29

• troponin and cardiac enzymes

Question 30

nstemi an d unstable engine ismlilar ecg how differentiate

Answer 30

troponin release with nstemi