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Flashcards in 9. Chest Pain Deck (10)
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1

What 5 causes of chest pain require immediate management?

Acute coronary syndrome
Aortic dissection
Pneumothorax
PE
Borrhaave's perforation

2

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

3

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
Pleural effusion
Wide mediastinum on CXR

4

What are 5 features of a pneomothorax?

Pleuritic chest pain + breathlessness
Hyper-inflated chest wall with impaired expansion
Hyper-resonance
Absent breath sounds
Tracheal deviation in tension pneumothorax

5

What are 3 features of a PE?

Sudden SOB +/- pleuritic chest pain
Tachycardia
Risk factors present: previous DVT, long period of immobility, OCP

6

What are 2 features of boerhaave's perforation?

Sudden onset chest pain immediately after vomiting
Signs of pleural effusion

7

What drugs do patients with ACS needed to be started on?

MONABASH
Morphine + metoclopromide
Oxygen only if needed to keep sats > 94%
Nitrates for vasodilation
Antiplatelets- aspirin + other agents
Beta blockers
Ace inhibitors
Statins
Heparin

8

What are the 6 most common causes of acute chest pain?

Musculoskeletal inflammation
ACS
PE
Stable angina
Pleurisy
Oesophagitis

9

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
CBG: T2DM
Amylase: acute pancreatitis

10

What should STEMI patients receive in addition to MONABASH? What is the alternative to this if unavailable?

Angioplasty
Thrombolysis