Substernal chest pressure following exercise or stress and relieved by rest or nitroglycerin; nausea, SOB, diaphoresis, sternal chest pressure
Stable angina
Normal examination; possible transient S4
Stable angina
Diagnostic studies for Stable angina are?
ECG during episode of chest pain, treadmill stress testing, myocardial perfusion imaging
Chest pain; history of fever, dyspnea
Myocarditis
Physical findings of this are heart murmur, friction rub, fever?
Myocarditis
Diagnostic studies with myocarditis are?
ECG, chest radiograph, echocardiogram
Sharp, stabbing pain referred to left shoulder or trapezius ridge, usually worse during coughing or deep breathing; can be relieved by sitting forward; history of viral or bacterial infection, autoimmune disease
Pericarditis
Physical findings are fever before onset of pain, tachycardia, pericardial friction rub?
Pericarditis
Diagnostic studies for pericarditis are?
WBC, ESR, ECG, chest radiograph, echocardiogram
Chest pain on exertion, substernal and anginal in quality; fatigue, palpitations, DOE, dizziness, syncope
Aortic stenosis
Radial pulse diminished; narrow pulse pressure; loud, harsh, crescendo-decrescendo murmur heard best at second right ICS with patient leaning forward; thrill
Aortic stenosis
Diagnostic studies for aortic stenosis?
Echocardiogram, ECG, chest radiograph
Exertional chest pain, fatigue, palpitations, dizziness, DOE, syncope
Mitral regurgitation
Holosystolic, blowing, often loud murmur heard best at apex in left lateral position and decreases with inspiration; murmur can radiate to axilla and possibly back
Mitral regurgitation
Mitral regurgitation diagnostic studies?
Chest radiograph, ECG, echocardiogram
Productive cough of yellow or green or rust sputum, dyspnea, pleuritic pain
Pneumonia
Fever; tachycardia, tachypnea; inspiratory crackles; vocal fremitus; percussion dull or flat over area of consolidation; bronchophony; egophony
Pneumonia
Diagnostic studies of pneumonia?
Chest radiograph, sputum cultures, ABGs
Chest pain, varies in location and intensity; palpitations; anxiety; nonexertional pain of short dura¬ tion; history of Marfan syndrome
Mitral valve prolapse
Arrhythmias, possible midsystolic click heard over apex; heard best while patient is in sitting or squatting position; thoracoskeletal deformity common in children
Mitral valve prolapse
Diagnostic test for Mitral valve prolapse?
ECG, echocardiogram
Mild, localized chest pain, worse with deep breathing; recent URI
Pleuritis
Shallow respirations, local tenderness, pleural friction rub
Pleuritis
Diagnostic test for pleuritis?
chest radiograph
Substernal pain worse after eating and lying down; sour taste in mouth
Esophagitis
Epigastric pain with palpitation
Esophagitis
Diagnostic test Esophagitis?
Esophageal pH
History of injury or trauma; pain with deep breaths; splinting of chest wall
Chest trauma (rib fracture)
Shallow respirations; chest wall pain on palpitation
Chest trauma (rib fracture)
Diagnostic test chest trauma (rib fracture)
chest radiograph
Pain along sternal border, increases with deep breaths; history of exercise, URI, or physical activity
Costochondritis
Pain with palpitation over costochondral joints; normal breath sounds
Costochondritis
Diagnostic test of Costochondritis?
none
Unilateral chest pain; painful rash?
Herpes zoster
Normal breath sounds; vesicular rash along dermatome?
Herpes zoster
Diagnostic test of Herpes zoster
none
Epigastric pain 1 to 2 hr after eating, can be relieved by antacids; hematemesis and melena; risk factors include smoking and alcohol overuse
Peptic ulcer disease
Tenderness to palpitation in epigastric area; signs of hypovolemia
Peptic ulcer disease
Diagnostic test of Pepticulcer disease
Upper Gl radiograph, upper endoscopy, CBC
Right upper quadrant abdominal pain radiating to right chest, often after eating high-fat meal; nausea and vomiting
Cholecystitis
Positive Murphy sign; palpable gallbladder
Cholecystitis
Diagnostic test of Cholecystitis?
Gallbladder ultrasound
Severe epigastric or left upper quadrant abdominal pain radiating into left chest; pain worse in supine position; nausea, vomiting, fever
Acute pancreatitis
Left upper abdominal pain with palpation; hypotension
Acute pancreatitis
Diagnostic test of Acute pancreatitis?
Amylase, lipase, pancreas ultrasound or CT scan
Chest pain, SOB, cough, hemoptysis, history of cigarette smoking; history of pneumonia
Lung tumors
Normal examination or diminished breath sounds over tumor and dull percussion sound over tumor
Lung tumors
Diagnostic test of Lung tumors?
Chest radiograph, spiral CT of chest, bronchoscopy
Chest pain, SOB, diaphoresis, nausea; can relate to substance use
Cocaine and amphetamine use
Tachycardia, hypertension
Cocaine and amphetamine use
Diagnostic test of Cocaine and amphetamine use?
ECG, serial cardiac enzymes, drug screen
Precordial chest pain, history of stressful situations
Psychogenic origin
Normal examination
Psychogenic origin
Diagnostic test of Psychogenic origin?
ECG, chest radiograph, treadmill stress test if car¬ diac risk factors present.
Severe, acute onset, stabbing, paroxysmal, pleuritic pain over lower rib cage and substernal edge; headache, malaise, nonproductive cough
Pleurodynia
Pleural friction rub 25% of time; chest examination normal; fever usually present
Pleurodynia
Diagnostic test of Pleurodynia?
Chest radiograph
Sudden, sharp, nondistressing pain near apex of heart; seen in adolescents
Precordial catch syndrome
Normal examination
Precordial catch syndrome
Diagnostic test of Precordial catch syndrome?
Chest radiography, ECG
