Chest Pain and Acute Coronary syndrome Flashcards
What can chest pain originate from?
Cardiac causes
Respiratory causes
GI causes
Musculoskeletal causes
In stable angina when do patients get pain?
only on exertion when metabolic requirements of the heart increase.
What is acute coronary syndrome?
Atheromatous plaque ruptures. Thrombus forms giving acute occlusion leading to ischaemia.
Unstable angina
MI- STEMI and NSTEMI
Outline the pathophysiology of ischaemic heart disease.
Atherosclerosis builds up over time. Lipid laden core with a fibrous cap.
What are the risk factors for ischaemic heart disease.
modifiable- smoking, HTN, cholesterol, DM, obesity and sedentary lifestyle.
non-modifiable- Age, FH, gender
What aggravates MI / ischaemia pain?
exursion
describe features of pericarditis pain.
Sharp central
Aggrovated on lying flat
Relieved sat up leant forward
What is costal chrondritis and how does it present?
Inflammation of rib cartilage
sharp well localised pain
tender on palpation
Inspiration/ cough aggrovates
What aggravates MI / ischaemia pain?
exertion
describe features of pericarditis pain.
Sharp central
Aggravated on lying flat, coughing and inspiration
Relieved sat up leant forward
Audible pericardial rub with stethoscope
Signs of infection and a pain to the side of the chest suggest?
Pneumonia
Compare visceral and somatic pain.
Somatic pain is from the serous and is sharp, well localised and worsen with positions.
Visceral pain is from the organ itself and is dull and poorly localised. Worse on exertion.
What would an aortic dissection feel like
Sharp pain that radiates to the back
Feels like tearing
Who is most at risk of pericarditis?
Adult men
What does the ECG look like in pericarditis?
Wide spread ST elevation - saddle shaped
