Chest Pain Flashcards

1
Q

Cardio Causes

A
  • ACS
  • Aortic Dissection
  • Pericarditis
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2
Q

Resp Causes

A
  • Pneumothorax
  • PE
  • Pneumonia
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3
Q

Gastro Causes

A
  • Peptic Ulcer

- Ruptured Oesophagus

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4
Q

MSK Causes

A

Costrochondritis

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5
Q

Other

A

Shingles

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6
Q

ACS Mx

A

ABCDE approach

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7
Q

Bedside Ix

A

ECG

  • Rule out ACS
  • Check for sinus tachy/S1Q3 wave in PE
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8
Q

Scoring Sx

A

Well score for PE
<4 = unlikely - do d dimer (CTPA if +ve, doppler if -ve)
>4 = likely - do CTPA (rx LMWH)

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9
Q

Bloods

A
FBC, UEs, LFTs, 
Troponin
CRP
Clotting
D dimer (if indicated)
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10
Q

Imaging

A

CXR - rule out pneumothorax, pneumonia

CT - ?dissection

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11
Q

Special Tests

A

Endoscopy
- Ulcer/upper GI bleed

CTPA

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12
Q

CVD risk factors

A

Non-modifiable

  • Age, male, ethnicity
  • Family hx IHD or ACS,
  • CKD, RA, diabetes, AF, hypothyroid

Modifiable

  • Smoking
  • Cholesterol
  • Blood pressure
  • Weight
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13
Q

RED FLAGS

A

Must rule out ACS

  • Severe, acute onset crushing central chest pain
  • Radiates to jaw and arm
  • Not relieved by GTN
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14
Q

PE Risk Factors

A

THROMBOSIS

Travel
Hypercoaguable/HRT
Recreational drugs
Old (>60)
Malignancy
Birth control pill
Obesity/obstetrics
Surgery/smoking
Immobilization
Sickness (CHF/MI, IBD, nephrotic syndrome, vasculitis)
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15
Q

Social Hx

A
  • Smoking
  • Alcohol
  • Diet and exercise
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16
Q

Drug Hx

A
  • NSAIDs
  • Steroids
  • BP/diabetes meds
17
Q

Fam Hx

A
  • IHD
  • ACS
  • Thrombophilia
18
Q

Systems

A
  • SOB?
  • Cough/haemoptysis
  • Haematemesis