Differentials

Question 1

What are the diferentials for retrosternal chest pain?

Answer 1

Angina - relieved by rest, if brought on by exercise

Acute MI – Pain would last longer than 5min and would not be relieved by rest

Acute pericarditis – tends to be more constant pain that is aggravated with inspiration, lyoing flat and moving

GORD – often a burning pain that is more common after eating and lying down plus relieved with antacids/PPI

Pneumonia – pleuritic chest pain (sharp pain on inspiration) also purulent sputum

PE – haemoptysis

Aortic dissection – more constant pain

Gallstones – may cause acute cholecystitis but pain is not related to exercise

Musculoskeletal – worse on movement and may have injury to the chest/spine.

Question 2

What are the differentials for SOB?

Answer 2

LUNGS → Asthma, COPD, lung cancer, sarcoidosis
HEART → aortic dissection, cardiomyopathy, heart failure, PE
HAEMATOLOGY → Anaemia, hypothyroidism, sepsis, anxiety