PC: Chest Pain Flashcards
how can you explore the symptom of chest pain
using socrates
what does socrates stand for
site onset character radiation associated symptoms timing exacerbating/ relieving symptoms severity
what relevant systems review questions could you ask
general: fever, sweats
Cardiorespiratory: palpitations, SOB/wheeze, cough, sputum, leg swelling
asking about mental health.
name some of the main cardiac differentials
MI
angina
aortic dissection
pericarditis
name some respiratory differentials
pulmonary embolism
pneumothorax
pneumonia
name some non cardiorespiratory differentials
GORD
anxiety, panic attack
MSK / costochondritis
gastritis
what clues/symptoms help you to differentiate an MI
crushing central chest pain
radiates to neck/left arm
associated nausea/vomiting SOB
cardiovascular risk factors
name some cardiovascular risk factors
smoking diabetes HTN high cholesterol obesity increasing age male gender family history
what clues/symptoms help you to differentiate angina
cardiac type chest pain
associated with exertion
received by rest
what clues/symptoms help you to differentiate aortic dissection
tearing chest pain of very sudden onset
radiates to the back
pain in other sites like arms, leg, neck and head
what clues/symptoms help you to differentiate pericarditis
retrosternal/precordial pleuritic Chest Pain
received by sitting forward
may radiation to trapezius ridge/neck/shoulder
what clues/symptoms help you to differentiate pulmonary embolism
pleuritic chest tpain
Haemoptysis and SOB
risk factors (immobility, recent surgery, long haul flight)
what clues/symptoms help you to differentiate pneumothorax
sudden onset pleuritic chest pain
may be SOB if large
risk factors ie Marfans’s syndrome
COPD/asthma
what clues/symptoms help you to differentiate GORD
retrosternal burning chest pain
related to meals, lying, straining
water brash (lots of saliva)
what clues/symptoms help you to differentiate anxiety/panic attack
tight chest pain, SOB, sweating, dizziness, palpitations, feelings of impending doom
anxious personality and other symptoms of generalised anxiety disorder
recurrent episodes triggered by a stimulus
what clues/symptoms help you to differentiate MSK
sharp chest pain
exacerbated by movement or inspiration
can point to where it is worse
exacerbated boy pressure over the area
what condition are these classically symptoms of: crushing central chest pain radiates to neck/left arm associated nausea/vomiting SOB cardiovascular risk factors
MI
what condition are these classically symptoms of:
cardiac type chest pain
associated with exertion
received by rest
angina
what condition are these classically symptoms of:
tearing chest pain of very sudden onset
radiates to the back
pain in other sites like arms, leg, neck and head
aortic dissection
what condition are these classically symptoms of:
retrosternal/precordial pleuritic Chest Pain
received by sitting forward
may radiation to trapezius ridge/neck/shoulder
pericarditis
what condition are these classically symptoms of:
pleuritic chest tpain
Haemoptysis and SOB
risk factors (immobility, recent surgery, long haul flight)
pulmonary embolism
what condition are these classically symptoms of:
sudden onset pleuritic chest pain
may be SOB if large
risk factors ie Marfans’s syndrome
COPD/asthma
pneumothorax
what condition are these classically symptoms of:
retrosternal burning chest pain
related to meals, lying, straining
water brash (lots of saliva)
GORD
what condition are these classically symptoms of:
sharp chest pain
exacerbated by movement or inspiration
can point to where it is worse
exacerbated boy pressure over the area
MSK
