CHEST PAIN AND SENSORIUM Flashcards
recent onset of pain, pressure, or tightness in the anterior thorax between the xiphoid, suprasternal notch and both midaxillary lines
chest pain
________ includes:
Acute myocardial infarction
acute ischemia/unstable angina
acute coronary syndrome
type of chest pain
retrosternal left anterior chest crushing, squeezing, tightness or pressure
classic features of ACS
Radiation to the neck, arms or jaw
diaphoresis
dyspnea
nausea and vomiting
classic cardiac pain
chest pains lasting for 12-24 hours or more without waxing and waning intensity or pain worsened by specific body movements or positions
non-classic cardiac pain
innervates the chest wall from the dermis to the parietal pleura
pain from somatic fibers is usually easily described, precisely located and often experienced as a sharp sensation
somatic pain fibers
found in the internal organs such as the heart, esophagus and visceral pleura
patients with visceral pain are more likely to use terms such as discomfort, heaviness, pressure, tightness or aching
visceral pain is often referred to an area of the body corresponding to adjacent somatic nerves
visceral pain fibers
angina occurring at rest and that is prolonged usually >20 minutes
rest angina
new onset angina that markedly limits ordinary physical activity
new onset angina
previously diagnosed angina that has become distinct more frequent has a longer duration or is lower in threshold, limiting ability to walk 1-2 blocks or climb 1 flight of stairs
increasing angina
_________ occurs when there is an imbalance of oxygen demand and oxygen supply
ischemia
influenced by the oxygen carrying capacity of the blood and the coronary artery blood flow
oxygen supply
determined by the amount of hemoglobin present and oxygen saturation
oxygen carrying capacityuni
universal sign of ischemic chest pain
defines as an individual holding a clenched fist over the chest that has low sensitivity but is a relatively specific ischemia
levine sign
ST segment elevations in V1, V2 and possibly V3
anteroseptal
ST segment elevations in V1, V2, V3, and V4
anterior
ST segment elevations in V1-V6, I, and aVL
anterolateral
ST segment elevations in I and aVL
Lateral
ST segment elevations in II, III, and aVF
inferior