Flashcards in 9. Chest Pain Deck (10)
What 5 causes of chest pain require immediate management?
Acute coronary syndrome
What are some of the features of ACS?
Sudden onset crushing pain
Radiates to the arm/ jaw
Hx angina/ CVS risk factors
Signs of hypercholesterolemia (xanthomata)
Signs of PVD (carotid bruits, weak pulses)
Signs of Brady-/ Tachyarrythmia
What are 7 features of aortic dissection?
Tearing pain to the back
Absent pulse in 1 arm
Difference in BP between 2 arms >20 mmHg
Hx of HTN
New onset aortic regurgitation
Wide mediastinum on CXR
What are 5 features of a pneomothorax?
Pleuritic chest pain + breathlessness
Hyper-inflated chest wall with impaired expansion
Absent breath sounds
Tracheal deviation in tension pneumothorax
What are 3 features of a PE?
Sudden SOB +/- pleuritic chest pain
Risk factors present: previous DVT, long period of immobility, OCP
What are 2 features of boerhaave's perforation?
Sudden onset chest pain immediately after vomiting
Signs of pleural effusion
What drugs do patients with ACS needed to be started on?
Morphine + metoclopromide
Oxygen only if needed to keep sats > 94%
Nitrates for vasodilation
Antiplatelets- aspirin + other agents
What are the 6 most common causes of acute chest pain?
What blood tests are helpful for diagnosing cause of chest pain?
Troponin (>,3 hours after onset or CK-MB)
Cholesterol (though decreases post-infarct)
FBC: coexisting anaemia
U+Es: Hyperkalaemia can cause arrhythmia
WCC + CRP: inflammation
Amylase: acute pancreatitis