Heart&VesselsTable 19-2

Question 1

Angina Pectoris

Answer 1

CD: pressure like discomfort, last 3-5 min
L/R: generalized substernal or retrosternal, jaw, should
PAS: diaphoresis, n/v, dyspnea

Question 2

Preinzemtal or variant angina

Answer 2

CD:pressure like discomfort often occurring at rest or early am
L/R: retrosternal, jaw, neck, l arm or shoulder
PAS:palpation, syncope, or feelings of syncope

Question 3

Acute Coronary syndrom

Answer 3

CD: heaviness; viselike, squeezing, crushing tightness, vague burning, lasting 20-30 min
L/R: generalized substernal or retrosternal: can radiate to teeth, jaw neck, one or both arms, or sternal
PAS: Indigestion like, feeling n/v, dizziness, flushing, perspiration, palpation, dyspnea.

Question 4

pericarditis

Answer 4

CD: sudden sharp and stabbing pain, relieved often by sitting/ leaning forward and worsens by lying down or inspiration
L/R: substernal, can radiate to trap
PAS: dry cough muscle and joint aches, fever

Question 5

mitral valve prolapse

Answer 5

CD: sharp pain not associated with activity
L/R: chest pain without radiation
PAS: fatigue, light-headedness, dyspnea, irregular heartbeat, palpitations, exercise intolerance

Question 6

aortic dissection

Answer 6

CD: sudden sever pain with changes in location and or tearing sensation lasting hours
L/R: anterior chest pain with radiation to the neck, jaw, or intrascapular region of the back
PAS: mental status changes, limb pain and weakness, dyspnea

Question 7

pulmonary hypertension (secondary)

Answer 7

CD: cardiac like chest pain with excretion
L/R: chest region
PAS: dyspnea, lower-extremity edema, fatigue

Question 8

Pulmonary embolism

Answer 8

CD: sharp, stabbing pain worsening with deep breaths
L/R: pain can be experience in chest back, shoulder, or upper abdomen
PAS: dyspnea, hemoptysis, cough

Question 9

pneumonia

Answer 9

CD: sharp or stabbing pain associated with cough
L/R: mostly generalized to one side of chest but can have upper abdominal pain
PAS: cough fever dyspnea, chills, sputum, myalgia, malaise

Question 10

Pneumothoraz

Answer 10

CD: acute/sudden and sharp
L/R: Lateral region of the chest but can have referred pain to the shoulder
PAS: acute dyspnea and cough

Question 11

GI reflux

Answer 11

CD: may be angina like however usually burning sensation with eating large meals reproduced by lying down and relieved by sitting up
L/R: retrosternal region
PAS: cough regur. of food and ab pain

Question 12

Esophageal spasm

Answer 12

CD: crushing chest pain
L/R: substernal
PAS: dysphagia, sensation of object in throat of esophagus

Question 13

Cholecystitis

Answer 13

CD: sudden onset of pain that crescendos and can last for up to 20 minutes, usually after eating a fatty meal
L/R: Epigastrium or right upper ab that can radiate to right intrascapular region, shoulder or back
PAS: N/V anorexia, fever

Question 14

Pancreatitis

Answer 14

CD: Sudden dull, boring, steady pain unrelieved by lying supine; leaning forward or in the fetal position
L/R: epigastrium or periumbilical pain radiating to back
PAS: n/v, anorexia, and sometimes diarrhea

Question 15

Herpes Zoster

Answer 15

CD: Unilateral, burning, borelike pain
L/R: chest region in dermatome distribution
PAS: tingling, itching, burning

Question 16

Costochondritis

Answer 16

CD: sharp, pleuritic-type pain worsens with deep breathing, palpation or movement
L/R: Area from 2nd through 5th intercostal spaces; can radiate to arm, depending on where initial inflammation occurs
PAS: chest tightness, warmth at area of pain

Question 17

Chest wall muscle strain

Answer 17

CD: Sharp pain with moving stretching or pushing movements of arm, palpation of area reproduces the pain
L/R: area around the strained muscle, sternum or ribs
PAS: muscle spasm, crepitation, swelling, loss of strength.

Question 18

Depression

Answer 18

CD: heaviness
L/R: chest region
PAS: fatigue, restlessness, withdrawal, weight gain or loss, depressed mood

Question 19

Anxiety

Answer 19

CD: sharp pain
L/R: chest region
PAS: palpation, dizziness, sweating, shaking, restlessness, fatigue, irritiabilty