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Acute Chest Discomfort Flashcards

(90 cards)

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1
Q

Stable Angina

A

Precipitated by exertion, cold or stress

2-10 min

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2
Q

Unstable Angina

A

Increasing pattern or at rest

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3
Q

Myocardial Infarction

A

> 30 mins

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4
Q

Quality of pain in M.I

A

pressure, tightness, squeezing, heaviness, burning

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5
Q

Location of pain in M.I

A

retrosternal

radiation - neck, jaw, shoulders or arms

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6
Q

Associated features of M.I

A

S4 gallop or mitral regurgitation during pain

S3 or rales if severe ischemia

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7
Q

Pericarditis

A

variable; hrs - days; may be episodic

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8
Q

Quality of pain in pericarditis

A

pleuritic, sharp

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9
Q

Location of pain in pericarditis

A

retrosternal or toward the cardiac apex

radiation - L shoulder

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10
Q

Associated features of pericarditis

A

relieved by sitting up and leaning forward

pericardial friction rub

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11
Q

Acute Aortic Syndrome

A

sudden onset of unrelenting pain

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12
Q

Quality of pain in Acute Aortic Syndrome

A

tearing or ripping; knifelike

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13
Q

Location of pain in Acute Aortic Syndrome

A

anterior chest

radiation - back b/w shoulder blades

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14
Q

Associated features of Acute Aortic Syndrome

A

hypertension
underlying CT disorder
murmur (aortic insufficiency)
loss of peripheral pulses

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15
Q

Pulmonary Embolism

A

sudden onset

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16
Q

Quality of pain in Pulmonary Embolism

A

pleuritic

heaviness (massive PE)

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17
Q

Location of pain in Pulmonary Embolism

A

lateral (on the side of the embolism)

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18
Q

Associated features of Pulmonary Embolism

A

dyspnea, tachypnea, tachycardia and hypotension

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19
Q

Pulmonary Hypertension

A

variable (often exertional)

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20
Q

Quality of pain in Pulmonary Hypertension

A

pressure

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21
Q

Location of pain in Pulmonary Hypertension

A

substernal

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22
Q

Associated features of Pulmonary Hypertension

A

dyspnea, signs of increased venous pressure

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23
Q

Pneumonia or Pleuritis

A

variable

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24
Q

Quality of pain in Pneumonia or Pleuritis

A

pleuritic

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25
Location of pain in Pneumonia or Pleuritis
unilateral (localized)
26
Associated features of Pneumonia or Pleuritis
``` dyspnea cough fever rales occasional rub ```
27
Spontaneous Pneumothorax
sudden onset
28
Quality of pain in Spontaneous Pneumothorax
pleuritic
29
Location of pain in Spontaneous Pneumothorax
lateral to side of pneumothorax
30
Associated features of Spontaneous Pneumothorax
dyspnea | decreased breath sounds on side of pneumothorax
31
Esophageal reflux
10-60 min
32
Quality of pain in Esophageal reflux
burning
33
Location of pain in Esophageal reflux
substernal, epigastric
34
Associated features of Esophageal reflux
worsened by postprandial recumbency relieved by antacids
35
Esophageal spasm
2-30 min
36
Quality of pain in Esophageal spasm
pressure, tightness, burning
37
Location of pain Esophageal spasm
retrosternal
38
Associated features of Esophageal spasm
mimic angina
39
Peptic Ulcer
prolonged 60 - 90 mins after meals
40
Quality of pain in Peptic Ulcer
burning
41
Location of pain in Peptic Ulcer
epigastric, substernal
42
Associated features of Peptic Ulcer
relieved w/ food or antacids
43
Gallbladder disease
prolonged
44
Quality of pain in Gallbladder disease
aching or colicky
45
Location of pain in Gallbladder disease
epigastric, RUQ radiation: sometimes to the back
46
Associated features of Gallbladder disease
pain may follow meal
47
Costochondritis
variable
48
Quality of pain in Costochondritis
aching
49
Location of pain in Costochondritis
sternal
50
Associated features of Costochondritis
swollen, tender, warm over joint may be reproduced by localized pressure on examination
51
Cervical disk disease
variable; may be sudden
52
Quality of pain in cervical disk disease
aching; numbness
53
Location of pain in cervical disk disease
arms and shoulders
54
Associated features of cervical disk disease
exacerbated by movement of neck
55
Trauma or strain
constant
56
Quality of pain in trauma or strain
aching
57
Location of pain in trauma or strain
localized to area of strain
58
Associated features of trauma or strain
reproduced by movement or palpation
59
Herpes zoster
prolonged
60
Quality of pain in Herpes zoster
sharp or burning
61
Location of pain in Herpes zoster
dermatomal distribution
62
Associated features of Herpes zoster
vesicular rash
63
Acute, potentially life threatening condition that warrants urgent evaluation and management
Unstable IHD Aortic dissection Pneumothorax Pulmonary embolism
64
Chronic condition --> serious complication
aortic stenosis stable angina pulmonary hypertension
65
Acute conditions that need treatment
pericarditis pneumonia/pleuritis Herpes zoster
66
Retrosternal pain
MI pericarditis esophageal spasm emotional and psychiatric conditions
67
Substernal pain
pulmonary HPN | esophageal reflux
68
Epigastric pain
peptic ulcer gallbladder disease esophageal reflux
69
Lateral
pulmonary embolism | spontaneous pneumothorax
70
Variable onset of pain
``` pericarditis pulmonary hypertension pneumonia or pleuritis costochondritis emotional or psychiatric conditions ```
71
Sudden onset of pain
acute aortic syndrome pulmonary embolism spontaneous pneumothorax
72
Pleuritic
pericarditis pulmonary embolism pneumonia or pleuritis spontaneous pneumothorax
73
Burning
esophageal reflux peptic ulcer herpes zoster (sharp or burning) esophageal spasm (pressure, tightness, burning)
74
Aching
gallbladder disease (aching and colicky) costochondritis cervical disk disease trauma or strain
75
Gradual atherosclerotic narrowing of coronary arteries
Stable IHD
76
Ischemic episodes that are precipitated by increase in oxygen demand during physical exertion and relieved upon resting
stable angina
77
Presence or absence of detectable myocardial injury and presence or absence of ST segment elevation
unstable IHD
78
No detectable MI
unstable angina
79
With evidence of myocardial necrosis
non ST elevation
80
Coronary thrombus is acutely and completely occlusive, transmural MI w/ ST segment elevation and myocardial necrosis
STEMI
81
Encompasses unstable angina, NSTEMI and STEMI and reserved for ischemia precipitated by acute coronary atherothrombosis
acute coronary syndrome
82
The MC cause of nontraumatic chest discomfort
GI conditions
83
Tietze's syndrome
Costochondritis causing tenderness of the costochondral junctions
84
Chest x-ray - Widening of mediastinum
Aortic Dissection
85
Chest x-ray - Hampton's hump or Westermark's sign
Pulmonary Embolism
86
Chest x-ray - Chronic Pericarditis
pericardial calcification
87
The preferred biomarker for the diagnosis of AMI
cardiac troponin
88
Aid in exclusion of pulmonary embolism
D-dimer
89
HEART Score
``` History ECG Age Risk Factors Troponin (serial) ``` low risk - 0-3 high risk - >4
90
Sensitive technique for detection of obstructive coronary disease esp in the proximal third of the major epicardial coronary arteries
Coronary CT angiography

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