Chest Pain Flashcards
History of chest pain
OLDCARTS
Is pain substernal
Is pain provoked by exertion?
Is pain relieved by rest or nitroglycerin?
Angilal pain=has all three previous characteristics
High risk for CAD in all age groups
Atypical angina
Has two characteristics
has intermediate risk for for CAD in women older than 50 and in all men.
Nonanginal pain has one characteristic
intermediate risk for CAD in women older than 60 and men older than 40.
Specific symptoms=MI
Does pain radiate to both arms? Hypotension? S3 gallop? Diaphoriesis? Pleuritc chest pain? palpation of tender area reproduces chest pain?
Pneumonia
Egophony?
Dullness to percussion?
Fever?
Heart Failure
Exertional Dyspnea
Displaced apical impulse?
Panic disorder?
Yes on at least one item of Autonomic Nervous System Questionaire
Chest Wall pain
Palpation of tender area reproduces chest pain?
Chest Pain in women most common presentation and symptoms
Gastrointestinal, musculoskeletal, and Psychological
Chest pain-women
serum amyloid A (SAA) and CAD
in women. SAA is a protein synthesized
in the liver in response to inflammation
typically seen in atherosclerotic processes
Women
GERD is common in those with CAD
Cardiac physical exam
Inspect: PMI, displaced downward and laterally, anuerysmal-Skin-neck veins-thorax?-Fundoscopic
Palpation-carotid upstroke
Auscultation
S4 (heart failure) bruits
Women chest pain
presents with unusual fatigue and tiredness and sleep disturbance
Angina equivalent in elderly
See page 521 in Buttaro
Dyspnea appears stable when they ovvur with moderate exertion and unstable when they ovvur with minimum exertions. FATIGUE follows
