Murtagh - Chest pain cont. sites, radiation and features of chest pain syndromes Flashcards
pain distribution of myocardial ischaemia
retrosternal pain or pain situated across the chest anteriorly should be regarded as cardiac until proven otherwise
pain radiation of myocardial ischaemia
wide variation in sites of pain, umbilicus to jaw, including neck, inside of arms, epigastrium and interscapular
pain is referred to left arm more commonly than the right
best predictor of AMI is pain in both arms
quality of myocardial ischaemia pain
pressure, heaviness or tightness
associated symptoms of myocardial ischaemia
dyspnoea, dizziness, nausea, vomiting, sweating
if the retrosternal pain sounds like myocardial ischaemia, but it is elicited not be exertion but instead by bending, lifting, strains or lying down
oesophageal reflux and spasm may be the diagnosis
the pain of stable angina tends to last
a few minutes only
like 3-5 minutes
stable angina pain is relieved by
rest and glyceryl trinitrate (nitroglycerine)
stable angina pain may be precipitated by an
arrhythmia
how will creatinine kinase change with unstable angina vs. MI
with unstable angina creatinine kinase will be normal
with MI it will be elevated
when will troponin not be detectable
only in low risk unstable angina
high risk unstable angina and MI will have detectable troponin
how will unstable angina look on an ECG
low risk will look normal
high risk will have ST depression
will creatinine kinase be elevated in unstable angina
no it will be normal
it will be elevated for MI
Will unstable angina always show up on the ECG
no will low risk unstable angina the ECG will be normal
will creatinine kinase be elevated in MI
yes it will be elevated for both STEMI and NSTEMI
will troponin be detectable for MI
yes for both STEMI and NSTEMI
investigations for types of acute coronary syndromes
