1 Chest Pain Flashcards

1
Q

For patients with any abrupt, new, or severe chest pain, obtain an ECG within

A

10 minutes

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2
Q

For chest pain patients, administer oxygen if ambient saturation is

A

<94%

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3
Q

Nonclassic presentaitons ofr ACS occur more frequently in

A

Psychiatric patients
Altered mental status
Women
Diabetics
Elderly
Racial minorities

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4
Q

In these patients, include an ECG in routine evaluation of abdominal pain

A

Patients >50 y/o
Or those with known CAD

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5
Q

What is Boerhaave’s syndrome

A

Esophageal rupture
Classically presents with a history of sudden-onset sharp substernal chest pain following forceful vomiting.

When suspecting esophageal rupture, obtain a CT with oral-water soluble contrast

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6
Q

This refers to audible crepitus that varies with the heartbeat on auscultation of the precordium

A

Hamman’s crunch
A rare finding associated with pneumomediastinum.

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7
Q

Most specific physical examfinding for pericarditis

A

pericardial friction rub

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8
Q

chest pain of pericariditis

A

Worst with supine
Worsened by inspiration
Relieved by sitting and leaning forward

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9
Q

Classic ECG findings in pericarditis

A

Diffuse ST-segment elevation with PR depression

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10
Q

What is another name for costochondritis

A

Tietze syndrome

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11
Q

Panic disorder is characterized by:

A

recurrent, unexpected, and discrete periods of intense fear or discomfort with at least 4 of the following symptoms:

chest pain
dyspnea
palpitations
diaphoresis
nausea
tremers
choking
dizziness
fear of losing control
fear of dying
paresthesia
chills
hot flashes

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12
Q

Remarks with panic disorder

A

Do not assume panic disorder in a patients with chest pain in the ED until further testing allows better risk stratification.

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13
Q

Some conditions with elevated cardiac troponin levels in the absence of ischemic heart disease

A

Pulmonary hypertension
Arrhythmias
Pulmonary embolism
Aortic dissection

Burns
Extreme exertion (e.g., endurance athletes)
Acute neurologic disease (e.g., stroke, SAH)
Respiratory failure
Sepsis

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14
Q

In the setting of renal failure, elevation of ______ is more common than troponin I elevation

A

Troponin T

Patients with renal disease often have an elevated troponin T (15-50%), whereas Troponin I eleveations are less common (<10%)

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