Chest Pain History Taking Flashcards
SOCRATES
S- Point to me where the pain is (Site)
Onset - Have you had this pain before?
Character - What does it feel like?
R- Does the pain move anywhere else?
A - Associated symptoms -sweating, syncope, SOB, swelling, pain, palpitations
T- How long does the pain last
E- Anything makes the pain worse or better (Breathing in, flat, leaning forward)
S- Scale of 1-10
What are the causes of pleuritic chest pain?
Pleural effusion
Pneumothorax
Pericarditis
Pulmonary embolism
Features of an aortic dissection?
Sudden-onset tearing chest pain radiating to the back
Absent pulse in one arm (radial-radial delay)
Hypertension (in 50% of cases)
Features of ACS Pain?
Central, crushing radiating arm/neck/jaw
Features of PE pain?
SOB + pleuritic chest pain, leg swelling
Boerhaaves perforation?
Forceful vomiting before the chest pain
What is the main risk factor for aortic dissection?
Hypertension
Features of ruptured AAA?
Very sudden onset continuous abdominal pain in the flank region (severe) radiates to the back.
Features of vasovagal syncope?
Preceding symptoms of nausea, pallor, sweating, and faintness, visual fields may change, LOC
Risk factors: Emotional, pain, standing too long hot weather
Features of pericarditis?
Chest pain - described as sharp, worse when lying flat or during inspiration
Fever
Query recent illness or sick contacts
What are the features of heart failure?
SOB, cough, pink frothy sputum, orthopnoea, oedema
FHx
CVD, sudden deaths in family
PMHx
Hypertension
Hypercholesterolaemia
Stroke, PVD, heart disease
Surgery
Allergies
SHx
Smoking Alcohol Recreational drugs Occupation Exercise, diet, sleep Travel history-
DHx
Anti-hypertensives
DOACs/APs
COCP
