Chest Pain Flashcards
(18 cards)
Chest Pain
Differential Diagnosis
Deadly Six (PET MAC)
Pulmonary embolism
Esophageal rupture/mediastinitis
Tension pneumothorax
Myocardial infarction
Aortic dissection
Cardiac tamponade
Chest Pain
Differential Diagnosis
Cardiac
Pericarditis
Myocarditis
Endocarditis
Chest Pain
Differential Diagnosis
Respiratory
Pneumonia
Pleural effusion
Acute chest syndrome (sickle cell)
Lung or mediastinal mass
Chest Pain
Differential Diagnosis
Gastrointestinal
Esophagus – Mallory-Weiss tear,
esophageal spasm
Stomach – GERD, dyspepsia/PUD
Pancreas - pancreatitis
Gallbladder - biliary colic, cholecystitis, cholangitis
Chest Pain
Differential Diagnosis
Muscoloskeletal
Intramuscular pain
Rib pathology
Chest Pain
Other
Panic attack
Herpes Zoster
Chest Pain
Assessment: History
Character of pain
Cardiac risk factors (see HEART score)
PE risk factors (see PERC rule)
Recent trauma
Neuro symptoms
Chest Pain
Assessment: Physical Exam
Appearance
Cardiac exam
Resp exam
Neuro screen
Vitals +
Pulse deficits
Chest Pain
Investigations Test
ECG
CXR
+/- CTPA
Chest Pain
Investigations Labs
CBC
CMP
Troponin
+/- D-dimer
Chest Pain
Management
General
ABC
Monitors
Oxygen
Vitals
IV access
Chest Pain
Management
ACS
ASA
Nitro (avoid in RV infarct)
Clopidogrel/Ticagrelor
UFH
STEMI protocol (PCI vs. thrombolytics)
Chest Pain
Management
PE
Anticoagulation
+/- thrombolysis for massive PE
Chest Pain
Management
Esophageal Rupture
Urgent thoracics consult
IV antibiotics
NPO
Endoscopy and further imaging
Chest Pain
Management
Tension Pneumothorax
Needle decompression then chest tube (4th or 5th ICS anterior axillary line)
Chest Pain
Management
Tamponade
Pericardiocentesis
Chest Pain
Management
Dissection
Urgent vascular consult
Reduce BP and HR with IV
labetalol
Surgery vs. medical management
