chest pain (resp) Flashcards
3 important cardiac causes of chest pain
MI/ pericarditis/aortic dissection
4 important resp causes of chest pain
PE, pneumothorax, pnuemonia, pleural inflammation
3 important GI causes of chest pain
oesophageal spasam, dysmotility/reflux, oesophageal rupture
3 important MSK causes of chest pain
rib fracture/metastesis; muscle spasm/strain; costochondritis
what 4 other systems should be considered when looking for chest pain differentials
skin (herpes zoster); breasts; upper abdomen (panrease, biliary tree); brain (psychological states e.g panic attack)
what 3 key investigations should be done in someone presenting with chest pain
bloods; ECG; CXR/other imaging
when is pericardial pain typically eased
on leaning forwards
what findings on examination may indicate aortic dissection
radial-radial delay; discrepancy of BP between arms (with no PAD)
exacerbating factors for pneumothorax presentation
exertion, breathing
theory as to why pneumothroax occurs in tall, thing young men
grow so fast the lungs over expand in relation to pleura
commonest form of presentaiton for PE
SOB rather than chest pain
other presentaiton- chest pain, haemoptysis, syncope (sudden drop in LV input)
what blood investigation is key in PE
D-dimer - a fibrin degradation product, a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis
ECG finding for PE
sinus tachy; S1Q3T3 (deep Q wave, -ve T wave) => RV overload signs
CXR for PE
normal or may see pleural effusion and maybe even infarct penumonias
what is pneumomediastinum and what might it indicater
air leaking into the mediastinum - may indicate rupture of oesophagus which causes the air to leak in
