Chest Pain

Question 1

what are the main system involved in chest pain?

Answer 1

Cardiac -IHD, aortic dissection, pericarditis

Resp-PE, pneumonia, pneumothorax

GI-oesophageal spasm, Oesophagitis, gastritis

MSK-Costochondritis

Question 2

What are examinations that should help differentiate?

Answer 2

Chest-
heart sound, lung sounds

Abdo-tender, guarding, masses, etc

hands-infective signs, clubbing, pulse

Arm-BP IN BOTH ARMS, collapse pulse

Neck and head-just general signs-sweatiness, heamoptosis, etc

Question 3

What investigations can help for chest pain Ddx?

Answer 3

ECG Always 1st priority if suspect MI
Troponin’s, CKMB, Myoglobin-if neg, exercise test
cardiography

Question 4

What ECG changes do you see in MI?

Answer 4

STEMI-raised ST segment, peaked T waves, patho q waves
V1-4 anterior MI
Lateral-V5-6, I, Avl
inferior-rest