CVS: Chest Pain And Acute Cornary Syndromes Flashcards
Describe 4 common causes of chest pain and give examples.
- Cardiac causes: Ischaemia, pericarditis
- Respiratory causes: Pneumonia, Pulmonary embolisms
- Musculoskeletal: Rib fractures, costochondritis
- Gastrointestinal: Reflux
How would a patient with Cardiac Ischaemia present?
A dull retrosternum pain which is poorly localised and that can radiate to the jaw, neck and shoulders.
The pain gets worse with exertion.
How would a patient with pericarditis present?
A sharp retrosternum pain.
The position often influences the pain as it is eased when the patient is sitting up or learning forward, and worsened when the patient is lying down.
It is also made worse when the patient is required to move the chest wall e.g. When coughing or breathing deeply.
How does a patient with reflux present?
A burning pain which runs up the chest. The patient will say its worse when they lie flat or after food.
How will a patient with pneumonia present?
Pain slightly off to the side. Also present with signs of infection like a high temp or cough, sometimes breathlessness.
How will a patient with a pulmonary embolism present?
Sharp chest pain that is well localised. It is worse when the patient breaths in or coughs.
Describe how a patient with costochondritis will present.
Sharp, well localised pain that is tender to placate. Worse with movement of the chest wall.
Describe somatic pain.
Sharp, well localised pain that is worse with inspiration, coughing or positional movement. It normally affects the sac surrounding organs.
Describe visceral pain.
Dull, poorly localised pain which is worsened with exertion.
It is when the organ/tissue is affected.
Name some modifiable risk factors for contrary atheromas.
- Smoking
- Hypertension
- Hypercholesterolaemia
- Diabetes
- Obesity
- Sedentary lifestyle
Name some non-modifiable risks of coronary atheroma.
- Advanced Age
- Family history
- Male
Describe what happens during stable angina.
Heart tissue ischaemia occurs only when metabolic demands of cardiac muscle are greater than what can be delivered via coronary arteries.
What conditions full under the heading ACS (Acute Coronary Syndrome)?
- Unstable angina
- MI
- NSTEMI
- STEMI
What are acute coronary syndromes?
Atheromatous plaques rupture with thrombus formation which causes an acute increased occlusion leading to ischaemia.
Which of the following leads to heart tissue ischaemia:
A) unstable angina
B) NSTEMI
C) STEMI
A) Unstable angina: no enzyme leak
