simple 2- chest pain Flashcards
where does aortic dissection pain radiate to?
back
can aortic stenosis and MVP result in chest pain?
AS- anginal pain
MVP- atypical chest pain
Non-ischemic Cardiomyopathy
Usually does not manifest as chest pain but rather dyspnea or other CHF symptoms.
ventricular tachycardia presentation
MAY present with chest pain, but more commonly the symptoms are palpitations, lightheadedness and syncope.
The Three Criteria for Typical Angina
- Substernal chest discomfort with a characteristic duration and features
- Exertional in nature
- Relief with rest or nitroglycerin
Who is more likely to present with atypical features for angina
Patients who have diabetes, women, and the elderly
atypical angina presentation
weakness or shortness of breath on exertion. Those symptom are considered “anginal equivalents”.
stable vs unstable agina
Stable:
- predictable pattern of chest discomfort
- usually occurs with exertion or extreme emotion.
- relieved by rest or nitroglycerin in < 5-10 minutes.
Unstable:
- serious: chest pain that occurs at rest/min. exertion
- Or New onset angina (within 4-6 weeks) and angina that has worsening severity, frequency or duration
- Unstable angina is an acute coronary syndrome and requires emergency care.
Do moderate caffeine consumption and mitral valve prolapse increase the risk for coronary artery disease?
no
What is the best diagnostic test you could next perform for someone with suspected angina?
EKG
rule out an ST elevation MI, look for evidence of prior infarction (pathologic Q waves) and, occasionally, make other diagnoses such as pericarditis.
labs to evaluate angina
CBC- anemia? electrolytes BUN, Cr TSH- hypo/hyper thyroidism? fasting lipid panel ALT- before starting statin
which imaging could detect pulmonary embolism or aortic dissection?
chest CT
what does Clinical ASCVD include?
acute coronary syndromes, history of MI, stable or unstable angina, coronary or other arterial revascularization, stroke, TIA, or peripheral arterial disease presumed to be of atherosclerotic origin.
Metabolic Syndrome Criteria
3 or more:
Obesity: Waist circumference (men >102 cm (40 in), women >89 cm (35 in)
Triglycerides >150 mg/dL
HDL men < 40 mg/dL, women < 50 mg/dL
BP > 130/85 mmHg
Fasting glucose > 110 mg/dL
Positive Stress Test Follow-up
You could increase antianginal medication and follow for symptom relief,
or you could also order cardiac catheterization with intervention to improve symptoms. The angiogram will allow the cardiologist to directly visualize the coronary anatomy and potentially perform interventions on stenotic segments.
