Track ?: ACS?

Question 1

T/F. If relieved by nitro, chest pain is likely cardiac

Answer 1

F
Relief by nitro does support cardiac etiology but other etiologies (especially GI) will also be relieved by nitro. Use with caution

Question 2

“Atypical” chest pain

Answer 2

Trying to move away from this term by 2021 ACC chest pain guidelines
Recommend using “noncardiac” chest pain, but maybe a more appropriate term is low risk chest pain (using noncardiac chest pain may deter pt from returning to ED if chest pain returns or worsens)

Question 3

“Warranty period” in 2021 ACC guidelines

Answer 3

authors argue for a “warranty period” of prior cardiac testing
Normal angio: 2 years
Clean CCTA: 2 years
Normal stress: 1 year
** This could be dangerous, although these prior cardiac testing if normal reduce the likelihood of ACS, should not be placing “warranty”
**Also negative stress can often occur with balanced ischemia

Question 4

Chest discomfort verus chest pain?

Answer 4

2021 ACC guidelines
Chest discomfort may be a more appropriate term

Question 5

2021 ACC chest pain guidelines
ACS in women?

Answer 5

Women are less likely to get timely and appropriate care
Women are more like to have alternative symptoms than men (but chest pain is still the #1 symptom reported), more likely to present with MORE sxs than men