Chest Pain, Angina,MI Flashcards
What can cause chest pain ? (4)
- Respiratory causes (pneumonia,embolism)
- Upper GI condition (reflux)
- Muculoskeletal (rib fracture, costochrondiritis)
- Cardiac (heart muscle=Ischaemia , pericarditis)
Describe the difference in pain between visceral (lung and heart) and somatic (pleural and pericardial)
-Visceral:
.Dull,poorly localised
.Worse with exertion
-Somatic:
.Sharp,localised
.Worse with inspiration,coughing,movement
What is pericarditis and how does it present ?
-Inflammation of the pericardium , often after viral illness
.Retrosternal .sharp .localised (front) .worse with lying flat ,coughing and inspiration .better sit up, forward .PERICARDIAL RUB (harsh noise)
What does pericarditis look like on ECG ?
ST elevation, widespread, saddle-shape
Different from STEMI
What is Ischaemic heart disease ?
Disease of the coronary arteries due to atherosclerosis leading to poor perfusion of tissue
What are the modifiable risk factors of atherosclerosis (=IHD)
- smoking
- hypertension
- hypercholesterolaemia
- diabetes
- obesity
- sedentary life
What are the non-modifiable risk factors for IHD ?
- Advanced age
- Family history
- Male
An acute coronary syndrome includes …?
- Unstable angina
- NSTEMI
- STEMI
What is the typical symptom history of stable angina , when do they occur ?
- Dull
- Retrosternal
- Triggered by exertion
- not at rest
-only occur when metabolic demands of cardiac muscle greater than what can be delivered by coronary arteries
Why does angina occur ?
Atherosclerosis ,narrowing of coronary arteries , Ischaemia
What are Acute Coronary Syndromes ?
Acute myocardial Ischaemia caused by atherosclerotic coronary artery disease
Atheromatous plaque ruptures with thrombus formation causing ACUTE occlusion leading to Ischaemia
What is the common pathophysiology mechanism of ACS ?
atherosclerotic plaque rupture > platelet aggregation and formation of thrombus>partial occlusive thrombus>complete occlusion
For which ACS will you see cardiac enzyme in blood test ?
Infarction
NSTEMI,STEMI
What are the features of unstable angina ? (Pain)
- Occurs at rest
- more intense and longer than stable angina
- Acute deterioration
What are the features of MI ?
- Retrosternal,dull
- More severe than angina
- Radiate
- Even at rest
- Sweating,pale,nauseous(autonomic features)
- Pain for more than 15 min
