Outpatient Evaluation of the Adult with Chest Pain

Question 1

List cardiac etiologies of chest pain:

Answer 1

Myocardial ischemia 
Aortic Dissection
Heart Failure
Pericarditis/Myopericarditis 
Stress cardiomyopathy
Mitral valve disease

Question 2

List pulmonary etiologies of chest pain:

Answer 2

Pulmonary embolism
Pneumothorax
Pneumonia
Malignancy
Asthma/COPD
Pleuritis
Sarcoidosis

Question 3

List Gastrointestinal etiologies of chest pain:

Answer 3

GERD
Esophageal pain
Esophagitis
Eosinophilic esophagitis 
Esophogeal rupture

Question 4

List Musculoskeletal etiologies of chest pain:

Answer 4

Isolated MSK chest pain syndrome
Rheumatic disease
Rib pain
Trauma

Question 5

List some “other” etiologies of chest pain:

Answer 5

Substance related
Referred pain
Herpes zoster
Domestic violence

Question 6

List classic symptoms of myocardial ischemia:

Answer 6

pressure, heaviness, tightness, or constriction in center or left of the chest that is precipitated by exertion and relieved by rest

Question 7

What etiology might you suspect in the patient with acute chest and back pain that is severe, sharp and has a ripping or tearing quality?

Answer 7

Aortic dissection

Question 8

What etiology might you suspect in a patient with progressive dyspnea, cough, fatigue, and peripheral edema?

Answer 8

Heart failure

Question 9

What might you suspect in a patient who has chest pain that improves with sitting or leaning forward?

Answer 9

pericarditis

Question 10

What are the most common symptoms of pulmonary embolism?

Answer 10

dyspnea, followed by pleuritic chest pain, cough and sxs of deep venous thrombosis

Question 11

what etiology might you suspect in a patient with pleuritic chest pain, fever and productive cough?

Answer 11

pneumonia