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Progress Test Practice > Chest Pain L/Os > Flashcards

Chest Pain L/Os Flashcards

1
Q

What is the most common cause of death worldwide?

A

Ischaemic heart disease

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2
Q

What is the chief risk factor for cardiovascular mortality?

A

Smoking

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3
Q

What are some key processes in smoking cessation?

A
  1. Ensure they want to quit
  2. Enumerate the positives of quitting smoking
  3. Invite patient to choose a date where they will become a non-smoker
  4. Nicotine gum may be used to release small amounts of nicotine
  5. Transdermal nicotine patches
  6. Varenicline is an oral selective nicotine receptor partial agonist, however this can give you a dry mouth, appetite changes, taste disturbance, headache and drowsiness etc
  7. Bupropion with patches but there are SE of seizures, insomnia and headache
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4
Q

What demographic is at highest risk of CVD?

A

South Asian, Male

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5
Q

What risk score is used to assess risk factors for CVD?

A

Framingham score for south Asian men. However the QRISK2 score is better in the UK.

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6
Q

What should you always think when cardiac-sounding chest pain presents?

A
  1. Dissecting aortic aneurysm
  2. MI
  3. Pericarditis
  4. Pulmonary Embolism
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7
Q

Does GTN relieve oesophageal spasm?

A

Yes but much slower than angina

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8
Q

Can MI cause vomiting, nausea and sweating?

A

Yes

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9
Q

What are some causes of angina?

A

Coronary artery disease, aortic stenosis, hypertrophic cardiomyopathy, paroxysmal supraventricular tachycardia

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10
Q

How would you treat an acutely ill cardiac patient?

A
  • admit to hospital
  • check pulse and BP in both arms (unequal in aortic dissection)
  • JVP, heart sounds, examine legs for DVT
  • O2 by mask
  • IV line
  • pain relief e.g. morphine 5-10mg slowly (2mg/min) and an anti-emetic
  • cardiac monitor with 12 lead ECG
  • CXR
  • ## ABG
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11
Q

What is a key sign of cardiac tamponade?

A

Cardiogenic shock with raised JVP

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12
Q

What can cause cardiac tamponade?

A
  • pericarditis
  • injury to heart
  • cancer in or near the heart
  • ruptured heart muscle
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13
Q

What are some signs of a fractured rib?

A

pain on respiration, pain on gentle sternal pressure

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14
Q

What are causes of dyspnoea?

A
  • LVT
  • Pulmonary embolism (acute onset, ask for DVT RFx)
  • respiratory cause
  • anxiety
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15
Q

What are some causes of palpitations?

A
  • SVT, VT, AF and ectopics
  • thyrotoxicosis
  • anxiety
  • rarely phaeochromocytoma
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16
Q

Why is it important to ask about recovery from syncope?

A

Rapid recovery = arrhythmia

Prolonged with drowsiness = seizure

17
Q

What does angina mean in latin?

A

To choke or strangle

18
Q

What is the Levine-sign?

A

It is non-verbal cue when a patient clenches fist over sternum.

19
Q

What makes you suspect aortic dissection?

A
  • typically described as sharp
  • pain between shoulder blades
  • sudden
  • radiates to back
  • autonomic upset is common
  • syncope may occur
20
Q

What makes you suspect PE?

A
  • pleuritic pain
  • sudden-onset
  • central pain that mimics MI if severe
  • dyspnoea
  • haemoptysis
  • in massive PE can get syncope or shock
  • majority arise from DVT
21
Q

What are signs and symptoms of acute pericarditis?

A
  • constant retrosternal pain
  • sharp and stabbing
  • radiates to shoulders, arms, trapezius ridge
  • may be accompanied by pericardial (friction) rub
  • pain worse in inspiration and lying down
  • eased by sitting forwards
22
Q

What are the signs and symptoms of GORD?

A
  • severe retrosternal discomfort or pain
  • heart burn like symptom
  • radiates upwards
  • can experience cardiac like intense pain as a result of reflux-induced spasm
  • worse by lying down or bending over
  • often a history of recent weight gain
  • -> can result in oesophageal rupture
23
Q

What are signs and symptoms of pneumothorax?

A
  • unilateral pain
  • sudden pleuritic chest pain
  • associated with breathlessness
  • in large ones: hyper-resonance to percuss and absent breath sounds
24
Q

What are signs and symptoms of malignant chest wall invasion?

A
  • not associated with breathing

- constant, unremitting localised pain

Progress Test Practice (8 decks)

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