Differential Diagnosis: Chest Pain Flashcards

Question 1

Q

Stable Angina

Answer

A

History: Substernal chest pressure following exercise or stress and alleviated by rest or NTG; nausea; SOB; diaphoresis; sternal chest pressure

Physical Findings: Normal exam; Possible transient S4

Diagnostic Criteria: ECG during pain; treadmill stress test; myocardial perfusion imagery

Question 2

Q

Myocarditis

Answer

A

History: Chest pain; hx of fever; dyspnea

Physical Findings: heart murmur; friction rub; fever

Diagnostic Criteria: ECG; CXR; ECG

Question 3

Q

Pericarditis

Answer

A

History: Sharp, stabbing pain referred to left shoulder or trapezius ridge, usually worse during coughing or deep breathing; can be relieved by sitting forward; hx of viral or bacterial infection; autoimmune disease

Physical Findings: fever before onset of pain; tachycardia, pericardial friction rub

Diagnostic Criteria: WBC, ESR, ECG, CXR, ECG

Question 4

Q

Aortic Stenosis

Answer

A

History: chest pain on exertion; substernal and anginas in quality; fatigue; palpation; DOE; dizziness; syncope

Physical Findings: Radial pulse diminished; narrow pulse pressure; loud, harsh, crescendo-decrescendo murmur heard best at second right ICS with patient leaning forward

Diagnostic Criteria: ECG, Echo, CXR

Question 5

Q

Mitral Regurgitation

Answer

A

History: Exertional chest pain, fatigue, palpitations, dizziness, DOE, syncope

Physical Findings: holosystolic, blowing, often loud murmur heard best at apex in left lateral position and decreases with inspiration; murmur can radiate to axilla and possibly back

Diagnostic Criteria: CXR, ECG, echo

Question 6

Q

Pneumonia

Answer

A