Chest pain DDx

Question 1

Sharp chest pain relieved by sitting forwards?

Answer 1

Pericarditis

Question 2

Burning retrosternal pain?

Answer 2

GORD

Question 3

History of Marfan’s/other connective tissue disorders suggests what cause of chest pain?

Answer 3

Pneumothorax

Question 4

Examination finding which suggests dissecting aortic aneurysm?

Answer 4

Unequal upper limb blood pressures

Question 5

ECG features suggesting pulmonary embolism? (4)

Answer 5

S1Q3T3 (deep S wave in I, Q wave in III, inverted T wave in III)Sinus tachyRight axis deviationRight heart strain patternRBBB

Question 6

What suggests right heart strain on ECG?

Answer 6

Inverted T waves in the right praecordial leads (V1-V4) and inferior leads (II, III and aVF)

Question 7

Viral cause of chest pain?

Answer 7

Shingles

Question 8

Groups of patients who may present atypically with MI?

Answer 8

Elderly, diabetic

Question 9

ST elevation in II, III and aVF?

Answer 9

Inferior MI

Question 10

Which vessel is usually occluded in inferior MI?

Answer 10

Right coronary artery

Question 11

ST elevation in V1-V5?

Answer 11

Anterior MI

Question 12

Occluded vessel in anterior MI?

Answer 12

Left anterior descending

Question 13

ST elevation in I, aVL, V5-V6?

Answer 13

Lateral STEMI

Question 14

Occluded vessel(s) in lateral STEMI?

Answer 14

Left anterior descending and left circumflex

Question 15

In patients presenting with ischaemic symptoms, horizontal ST depression in the anteroseptal leads (V1-3) should raise the suspicion of….

Answer 15

posterior MI

Question 16

Pain of gastric ulcer is made worse by?

Answer 16

Immediately after eating

Question 17

How is Tietze’s diseases differentiated from costochondritis?

Answer 17

Tietze’s disease also involves palpable swelling of the costal cartilages