H19:95-103-Chest Discomfort Flashcards
Top 3 dx in patients with nontraumatic acute chest pain
GI 42%
IHD 31%
Chest Wall Syndrome 28%
Three mechanisms of myocardial O2 consumption
increased heart rate
increased wall stress
increased myocardial contractility
Difference between NSTEMI and UnStable angina
Myocardial necrosis in NSTEMI
Three complications of a Type A (Proximal) Aortic dissection
MI via obstruction of ostia
aortic insufficiency
pericardial tamponade
Define pleurisy
‘knife-like’ pain that is worsened by inspiration or coughing
Type of pain caused by PHTN
Angina-like
6 high risk conditions of principal concern in chest discomfort
ACS, Acute aortic syndrome, PE, Tension Pneumo, Preicarditis with tamponade, esophageal rupture
1 detail that decreased the likelihood of ACS
Inframammary location of the pain
1 major detail that increases the likelihood of ACS
radiation to right arm or shoulder (and both)
Explain postprandial angina vs. Peptic ulcer
both can occur 60-90 minutes PP. In PP angina a PANS redistribution of blood flow to the splanchnic vasculature causes demand ischemia.
6 anginal equivalents
Eructations, N/V, dyspnea, fatigue, faintness, diaphoresis
How quickly should an ECG be obtained once in the ED ?
10 minutes
Two major signs of MI on ECG
ST Depression of >1mv
Symmetric T-Wave inversions of >2mv in depth
Three things that can falsely elevate Troponin I
ESRD, Structural heart disease, interfering ABs
Two important qualities to Ti levels
increasing and at least one value in the 99th % reference limit.
