Chest Pain vs Dypsnea Flashcards
chest pain: angina pectoris
location?
quality?
problem r/t to?
timing?
aggravate?
factors that relieve?
symptoms?
retrosternal, anterior chest, radiates to shoulders, armss, neck, lower jaw, upper abdomen
quality: pressing, squeezing, heavy, burning
problem: cardiovascular
severity: mild - moderate ; discomfort rather than pain
timing: 1-3 mins but up to 10 mins; can be up to 20 mins
aggravate: exertion, colds, meals, emotional stress, at rest
relieve: rest, nitroglycerin
sx’s: dyspnea, nausea, sweating
chest pain: mycardial infarction
location?
quality?
timing?
aggravate?
factors that relieve?
symptoms?
retrosternal or chest radiating shoulders, arms, neck, lower jaw, upper abdomen
pressing, squeezing, tight, heavy, burning
severity: not always a severe pains
20 mins to few hrs
not always triggered by exertion
not relieved by rest
sx’s: dyspnea, nausea, vomiting, sweating, weakness
chest pain: pericarditis
problem r/t to?
location?
quality?
timing?
aggravate?
factors that relieve?
symptoms?
cardiovascular
retrosternal or left precordial, radiate to tip of left shoulder
sharp, knife like
severe
persistent
aggravate: breathing, changing positions, coughing, lying down , swallowing
seen in autoimmune, post MI, viral infection, chest irradiation
chest pain: aortic dissection
problem r/t to?
location?
quality?
timing?
aggravate?
factors that relieve?
symptoms?
cardiovascular
anterior or posterior chest, radiating to neck, back or abdm
ripping, tearing
very severe
abrupt onset, early peak, hrs +
aggravate: HTN
no relief
sx’s: if thoracic, Hoarseness dysphagia, also syncope, hemiplegia, paraplegia
chest pain: pleuritic pain (inflamm of parietal pleura)
problem r/t to?
location?
quality?
timing?
aggravate?
factors that relieve?
symptoms?
pulmonary
chest wall
sharp, knife like
severe
timing: persistent
aggravate: deep inspiration, coughing, movements of trunk
no relief
sx’s: underlying illness
What etiology? Dyspnea:
dyspnea progresses slowly
aggravate: lying down, exertion
relief: rest, sitting up, dypnea may be persistent
sx’s: cough, orthopnea, paroxysmal nocturnal dyspnea; wheezing
setting: hx of heart disease or predisposing factors
Left sided heart failure (L ventricular failure or mitral stenosis)
elevated pressure in pulmonary capillary bed w/ transduction of fluid into interstitial spaces and alveoli, decreased compliance (increased stiffness) of lungs, increased work of breathing
What etiology? Dyspnea:
chronic productive cough then slow progressive dyspnea
aggrevate: exertion, inhaled irritants, respiratory infections
relief: expectoration; rest, though dyspnea persistent
sx’s: chronic productive cough, recurrent respiratory infection, wheezing
setting: hx of smoking, air pollutants, COPD
chronic bronchitis
excessive mucus production in bronchi, after chronic obstruction of airways
What etiology? Dyspnea:
slowly, progressive dyspnea, mild cough later
aggravate: exertion
relief: rest, dyspnea peristent
sx’s: cough with scant mucoid sputum
setting: hx smoking, air pollutants
COPD
overdistention of air spaces distal to terminal bronchioles, with destruction of alveolar septa, alveolar and limitation of expiratory air flow
What etiology? Dyspnea:
acute episodes, then sx’ free periods; nocturnal episodes
aggravate: allergens, irritants, respiratory infxns, exercise, cold, emotions
relieve: remove irritants
sx’s: wheezing, cough, chest tightness
setting: environmental
asthma
reverisble bronchial hyperresponsiveness; release of inflammatory medaitors, increased airway secretions, bronchoconstriction
What etiology? Dyspnea:
progessive dyspnea; varies on the cause
aggravate: exertion
relief: rest; dyspnea persistent
sx’s: weakness, fatigue, (less common: cough)
setting: varied
diffuse interstitial lung diseaes
(sarcoidosis, widespread neoplasms, idiopathic pulmonary fibrosis, asbestosis)
abnormal & widespread infiltration of cells, fluid, collegen into interstitial spaces b/t alveoli; many causes
What etiology? Dyspnea:
acute illness, timing depends on cause
aggravate: exertion, smoking
relief: rest, persistent dyspnea
sx’s: pleuritic pain, cough, sputum, fever (may not be present)
pneumonia
infection of lung parenchyma from respiratory bronchioles to the alveoli
What etiology? Dyspnea:
sudden onset of tachypnea, dyspnea
aggravate: exertion
relief: rest, persistent dyspnea
sx’s: none, retrosternal oppressive pain if massive occlusion, pleuritic pain, cough, syncope, hemoptysis, and/or unilateral leg swelling and pain from instgating DVT, anxiety
setting: PP or post op; prolonged bed rest, HF, chronic lung disease, fractures of hip or leg, DVT, hypercoagulability, heredity or acquired (hormone therapy)
acute pulmonary embolism
sudden occlusion of part of pulmonary arterial tree by blood clot that usually originates in deep veins of legs or pelvis
