Chest Pain Flashcards
stable angina plan
Stress test, angiogram, labs for blood glucose and lipid panel
stable angina pt explanation
It sounds like you might have a problem called stable angina. This means there is a plaque narrowing one of the vessels that gives oxygen to your heart. To get a better understanding of what’s going on, we should plan for you to get a stress test, where doctors look at your heart while you exercise on a treadmill. You might also need imaging of the vessels around your heart, called an angiogram. We are also going to draw your blood to check your sugar and cholesterol to see what could be causing this.
GERD plan
Treat with 8 weeks of PPI and follow up to assess response
GERD pt explanation
I think that you have GERD, gastroesophageal reflux disease. Some people call this acid reflux, it is when acid from the stomach gets into your throat. We treat this with a medicine called a proton pump inhibitor that will help lower the levels of acid in your throat. We will try the medicine for 8 weeks and follow up to see if it is helping you.
MI plan
EKG within 10 minutes of arrival to ER, CK-MB and troponin, catheterization or anticoagulant meds
MI pt explanation
I’m worried that you might be having a heart attack. This is when a clot blocks blood and oxygen from getting to a part of your heart. You should go to the emergency room right away - we will make sure you get there safely. Once you are in the ER they will do an EKG, which will tell them about the electrical activity of your heart. They will also take your blood to see if your heart has been damaged. You will either get medicine or a procedure to remove the clot from the vessel in your heart.
unstable angina plan
oxygen, enoxaparin, aspirin, clopidogrel, beta blocker, nitrates
unstable angina pt explanation
I think that you have a condition called unstable angina. This is when one of the vessels bringing oxygen to your heart is blocked part of the way. You should go to the emergency room to get this evaluated more - we will make sure you get there safely. They will likely give you medicine to help get rid of the clot, and they will also give you oxygen there.
aortic dissection plan
Imaging to diagnose (usually CT or TEE, although angiography is gold standard), then surgery
aortic dissection pt explanation
I think you are having something called an aortic dissection. This is when two layers of a big blood vessel in your body separate and blood goes in between them. You should go to the emergency room right away - we will make sure you get there safely. You will have imaging done, like a CT scan, and then you will likely have to get a surgery.
pleural effusion plan
Imaging to diagnose (CXR, ultrasound), test fluid LD, protein, albumin, pH and cell count (transudative vs exudative), and thoracentesis if >1cm
pleural effusion pt explanation
It sounds like you have a pleural effusion. This is when fluid builds up between your lung and your chest. To get this evaulated, you will need to get imaging, like an x-ray or ultrasound of your chest. Doctors will also need to take a little bit of fluid with a needle to test it and see what is causing you to have this. They may need to drain it if there is a lot of fluid.
pericarditis plan
Echo to exclude tamponade, chest radiograph, BUN and Cr, TB test, antinuclear antibodies, blood cultures
pericarditis pt explanation
It sounds like you have a condition called pericarditis. This is when the tissue that surrounds your heart becomes irritated and inflamed. This condition usually gets better on its own with rest, but we need to do a few tests to rule out more serious problems. First, you will get a special ultrasound of your heart called an echocardiogram. We will also need to get an x-ray of your chest, and you will need to get blood drawn for a few labs looking to see if you have an infection or other condition.
MSK chest pain plan
Supportive care
MSK chest pain pt explanation
It sounds like you have injured a muscle in your chest, and that is what is causing your pain. You can take medicine like Motrin to get your pain under control, and make sure you rest the muscles as much as possible to heal quickly.
pulmonary embolism plan
“D-dimer, CT-PA to diagnose.
Thrombolytics/anticoagulants or catheterization to remove clot”
pulmonary embolism pt explanation
I think you have a pulmonary embolism, which is when a blood clot gets stuck in one of the arteries in your lungs. You should go to the ER. You will need to get a blood test done, and you might also need to get a special scan called CT-pulmonary angiography. If you do have a clot in your lungs, you will either be given medication to dissolve the clot, or you will need to get an operation to remove it.
peptic ulcer disease plan
“Lab tests for H pylori (breath test), endoscopy, or barium study to diagnose
Abx to kill H pylori if present, PPI, H2 blockers, antacids”
peptic ulcer disease pt explanation
It sounds like you have peptic ulcer disease, which happens when you get a sore (or an ulcer) on the inside of your stomach or intestines. This is sometimes caused by a bacterial infection caused by H. pylori, or by long-term use of medications like Motrin (NSAIDs). We will do some tests to see whether you have this bacteria or whether you have an ulcer caused by something else. This might involve using a camera to look at your throat and stomach. We might give you antibiotics if you are infected with the bacteria, or another kind of medication to reduce the amount of acid around the sore.
acute herpes zoster plan
“diagnose based on symptoms and rash, may need to take a sample of skin cells to look for microscopic changes usually caused by herpes zoster
treat w antivirals”
acute herpes zoster pt explanation
I think your pain is being caused by a virus called herpes zoster, which is sometimes called shingles. People who have chicken pox when they are kids can have this happen when they are older and the virus gets reactivated. You will need to get antiviral medications to treat this. Once you are healed, we should look into getting you vaccinted against shingles with the Shingrix vaccine, because it is possible to get shingles more than once.
costochondritis plan
EKG, xray or other imaging to rule out more serious conditions
costochondritis pt explanation
I think you have a condition called costochondritis. This is when the cartilage between your ribs and breastbone gets inflamed and can cause pain. We will likely do an EKG and get some imaging to rule out more serious causes. If you have costochondritis, we will help you get medications to control your pain. This problem heals on its own within a few weeks.
