L15 - Diagnosing Chest Pain

Question 1

What is pleuritic chest pain?

Answer 1

Sharp, well localised pain often worsened on inspiration/coughing/positional movement

Question 2

How would a patient describe their pain if it was cardiac related?

Answer 2

Dull/crushing, poorly localised, worsened with exertion

Question 3

Give some examples of non cardiac chest pain

Answer 3

Pneumonia/PE/acid reflux/costochondritis/rib fracture/aortic dissection

Question 4

Give some modifiable and non-modifiable risk factors for atherosclerosis and this ischaemic heart disease

Answer 4

Modifiable
-smoking/hypertension/dyslipidaemia (abnormal amount of lipids in blood)/diabetes/obesity/sedentary lifestyle

Non-modifiable - old/family history of early IHD/ male

Question 5

What is an acute coronary syndrome and what are they?

Answer 5

A spectrum of diseases resulting from increased coronary artery occlusion following plaque rupture

-unstable angina/NSTEMI/STEMI

Question 6

What ECG changes would be seen on someone’s with unstable angina/NSTEMI

Answer 6

ST depression

T wave inversion/flattening

Question 7

What ECG features might you see in STEMI?

Answer 7

Pathological q waves
ST elevation
Hyperacute T waves(see lec)/T wave inversion
Left bundle branch block