Oxford Cardio Cases

Question 1

5 common causes of chest pain in an individual >60 years

Answer 1

ACS
Stable angina 
PE
Pleurisy (secondary to infx)
Musculoskeletal

Question 2

Acutely life threatening chest pain ddx?

Answer 2

ACS, aortic dissection, pneumothorax, PE, Boerhaave’s perforation

Question 3

IX in chest pain cases?

Answer 3

ECG - particularly important to look for signs of new onset LBBB or ST elevation.

Blood tests - Troponin (on admission and 12h after the onset of pain), serum cholesterol, FBC (anaemia), U&Es (K+), inflammatory markers (may be raised in pericarditis), capillary glucose (untreated DM - more likely to have silent infarcts).

Imaging - Chest radiograph

Question 4

Pleuritic pain, worse on lying down, 2-10 weeks after MI. Dx?

Answer 4

Dressler’s syndrome - autoimmune pericarditis.