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Semester 2-CVS > Session 8-Chest Pain And ACS > Flashcards

Session 8-Chest Pain And ACS Flashcards

1
Q

What are some respiratory causes of chest pain?

A
  • pneumonia

- pulmonary embolism

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2
Q

What are some cardiac causes of chest pain?

A
  • ischaemia

- pericarditis

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3
Q

What are some upper GI causes of chest pain?

A
  • reflux

- peptic ulcer disease

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4
Q

What are some musculoskeletal causes of chest pain?

A
  • rib fracture

- costochondritis

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5
Q

What are the characteristics of ischaemic chest pain?

A
  • dull retrosternal pain
  • poorly localised
  • pain radiates to jaw, neck and shoulders
  • worse with exertion
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6
Q

What are the characteristics of chest pain due to pericarditis?

A
  • sharp retrosternal pain
  • eased with sitting up and leaning forward
  • worse when coughing and taking deep breaths
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7
Q

What are the characteristics of chest pain due to pneumonia?

A
  • raised temperature
  • cough
  • breathlessness
  • vague pain in affected area
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8
Q

What are the characteristics of chest pain due to pulmonary embolism?

A
  • sharp pain
  • localised
  • worse with inspiration
  • cough
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9
Q

What are the characteristics of chest pain due to costochondritis?

A
  • sharp well localised pain
  • tender to palpate
  • worse with movement of chest wall, coughing and inspiration
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10
Q

What is costochondritis?

A

Inflammation of costal cartilage

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11
Q

Describe visceral pain

A
  • dull, poorly localised

- worsened with exertion

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12
Q

Describe somatic pain

A
  • sharp pain, well localised

- worse with inspiration, coughing or positional movement

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13
Q

True or false: visceral pain is pain in the pleural sac and pericardial sac

A

FALSE - lung and heart (somatic is pleural sac and pericardial sac)

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14
Q

What is pericarditis?

A

Inflammation of pericardium

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15
Q

What can be heard on auscultation in a patient with pericarditis?

A

Harsh, coarse sound (pericardial rub)

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16
Q

What is synonymous with ischaemic heart disease?

A

Disease of coronary arteries

17
Q

What cap does an atherosclerotic plaque have?

A

Fibrous external cap

18
Q

What are the modifiable risk factors for atherosclerosis and therefore ischaemic heart disease?

A
  • smoking
  • hypertension
  • hypercholesterolaemia
  • diabetes
  • obesity
  • sedentary lifestyle
19
Q

What are the non-modifiable risk factors for atherosclerosis and therefore ischaemic heart disease?

A
  • advanced age
  • family history
  • male
20
Q

When does heart tissue ischaemia occur in stable angina?

A

Only when metabolic demands of cardiac muscle are greater than what can be delivered via coronary arteries

21
Q

What are the characteristics of stable angina?

A
  • dull, retrosternal chest pain
  • triggered by exertion
  • relieved by rest
  • no chest pain at rest
  • may get radiation to neck and shoulders
  • don’t feel particularly unwell-no sweating etc
  • GTN -> relieve pain
22
Q

Which conditions are classified as acute coronary syndromes?

A
  • unstable angina
  • MI
  • NSTEMI
  • STEMI
23
Q

What is an acute coronary syndrome?

A

Atheromatous plaques rupture with thrombus formation, causing acute increased occlusion, leading to ischaemia

24
Q

Complete the flow chart:

Atherosclerotic plaque rupture -> __________ aggregation and formation of ___________ -> partially occlusive ____________ -> completely occlusive ___________

A

Platelet
Thrombus
Thrombus
Thrombus

25
Q

Which acute coronary syndrome has the greatest occlusion?

A

STEMI

26
Q

Which acute coronary syndrome has the least occlusion?

A

Unstable angina

27
Q

True or false: unstable angina results in heart tissue ischaemia so there is no cardiac enzyme leak

A

TRUE

28
Q

What is released from necrosed cardiac muscle cells in infarctions (NSTEMI/STEMI)?

A

Cardiac enzymes

29
Q

What are the features of unstable angina?

A

Many similarities to stable angina except:

  • pain occurs at rest
  • pain may be more intense
  • pain may last longer
  • risk of deteriorating further -> NSTEMI or STEMI
30
Q

What are the characteristics of a myocardial infarction?

A
  • dull, retrosternal chest pain
  • may have history of stable angina
  • radiates to neck and shoulders
  • worse than stable angina
  • chest pain at rest
  • look unwell
  • features of increased autonomic output -> sweaty, pallor, nauseous
  • pain often ongoing for >15 minutes
  • nothing makes pain better
31
Q

Which diagnostic tests are used in suspected acute coronary syndrome?

A
  • ECG

- Blood tests

32
Q

What does the presence of troponin in the blood indicate?

A

Cardiac myocyte death

33
Q

What are the ECG changes in a STEMI?

A
  • ST segment elevation

- hyperacute T waves

34
Q

What are the ECG changes in unstable angina and NSTEMI?

A
  • ST segment depression

- T wave flattening or inversion

35
Q

How would you determine if the diagnosis was an unstable angina or NSTEMI?

A

Blood test - troponin release means cardiac muscle death -> infarct -> NSTEMI

Semester 2-CVS (18 decks)

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