Chest Pain Flashcards

1
Q

Differential of Chest Pain

A

So many! Anxiety, aortic stenoisis, asthma, cardiomyopathy, esophagitis, gastroenteritis, Hypertensive emergency, myocarditis, pericarditis, cardiac tamponade, aortic dissection, PE

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2
Q

Differential of Chest Pain

A

So many! Anxiety, aortic stenoisis, asthma, cardiomyopathy, esophagitis, gastroenteritis, Hypertensive emergency, myocarditis, pericarditis, cardiac tamponade, aortic dissection, PE

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3
Q

Classic presentation of ACS

A
Patient presents in early AM with substernal achy pressure pain radiates to anterior neck, shoulder, left arm and back.
50% "chest pain"
SOB
Nausea
Sweating
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4
Q

Risk factors of ACS

A
Past history of CAD
Smoker
HTN
Elevated cholesterol 
Diabetes
Family history
Elevated CRP
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5
Q

What will you find in Px of ACS?

A

Not much - clear chest, CV RRR without rub or murmur, abdomen soft, negative stool, no edema, diaphoretic skin

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6
Q

How might a young woman present with ACS?

A

SOB, sweaty, syncope, stroke, palpitation, indigestion, weakness
NOT PAIN

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7
Q

What is you hear S3 sound?

A

LV dysfunction

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8
Q

S4 sound?

A

Decreased left ventricular compliance (cannot occur in a fib)

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9
Q

Angina is a _______ not a ________

A

symptom; diagnosis

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10
Q

Why does angina occur?

A

Mismatched of O2 demand and delivery to cardiac muscle; results in ischemia

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11
Q

How long to angina symptoms last?

A
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12
Q

3 types of angina?

A
  1. Stable
  2. Prinzmetals
  3. Unstable
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13
Q

what type of angina is associated with ST elevations?

A

Prinzmetals

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14
Q

Grade IV angina?

A

Bad; at rest. No activity

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15
Q

Grade I

A

Angina only occurs with strenuous rapid or prolonged exertion at work or recreation

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16
Q

To diagnose MI.. You need to have elevated troponin and then….

A

One of the following:

  • symptoms of ischemia
  • Q wave development
  • New St/T wave changes or LBBB
  • Intracoronary thrombus
  • Loss of cardiac wall
17
Q

Classic presentation of ACS

A
Patient presents in early AM with substernal achy pressure pain radiates to anterior neck, shoulder, left arm and back.
50% "chest pain"
SOB
Nausea
Sweating
18
Q

Risk factors of ACS

A
Past history of CAD
Smoker
HTN
Elevated cholesterol 
Diabetes
Family history
Elevated CRP
19
Q

What will you find in Px of ACS?

A

Not much - clear chest, CV RRR without rub or murmur, abdomen soft, negative stool, no edema, diaphoretic skin

20
Q

How might a young woman present with ACS?

A

SOB, sweaty, syncope, stroke, palpitation, indigestion, weakness
NOT PAIN

21
Q

What is you hear S3 sound?

A

LV dysfunction

22
Q

S4 sound?

A

Decreased left ventricular compliance (cannot occur in a fib)

23
Q

Angina is a _______ not a ________

A

symptom; diagnosis

24
Q

Why does angina occur?

A

Mismatched of O2 demand and delivery to cardiac muscle; results in ischemia

25
Q

How long to angina symptoms last?

A

less than 30 minutes usually. 20 most often.

26
Q

3 types of angina?

A
  1. Stable
  2. Prinzmetals
  3. Unstable
27
Q

what type of angina is associated with ST elevations?

A

Prinzmetals

28
Q

Grade IV angina?

A

Bad; at rest. No activity

29
Q

Grade I

A

Angina only occurs with strenuous rapid or prolonged exertion at work or recreation

30
Q

To diagnose MI.. You need to have elevated troponin and then….

A

One of the following:

  • symptoms of ischemia
  • Q wave development
  • New St/T wave changes or LBBB
  • Intracoronary thrombus
  • Loss of cardiac wall