Chest pain

Question 1

Clin f of ACS

Answer 1

Sudden onset central crushing CP- radiates to L arm/jaw lasting longer than 20 min
Ass- diaphoresis, clamminess, nausea, SOB
Symptoms worsen with exertion and improve with GTN

Question 2

Clin f of stable angina

Answer 2

Sudden onset central CP radiating to L arm and jaw lasts for <20min with complete resolution of pain during rest
Triggered by exertion and resolved with GTN/ rest
Associated- SOB

Question 3

Clin f of pericarditis

Answer 3

Gradual onset
Central CP- worsened by laying flat and improved by leaning forward
Associated - fever, fatigue

Question 4

Clin f of thoracic aortic dissection

Answer 4

Sudden onset central CP radiating through back- tearing in nature
Associated- presyncope and syncope secondary to instability

Question 5

Clin f of pneumonia

Answer 5

Gradual onset sharp CP - worsened by deep inspiration
Associated- productive cough, SOB, fever, malaise

Question 6

Clin f of spon PTX

Answer 6

Sudden onset sharp CP worsened by deep inspiraiton
Associated- SOB, hemoptysis

Question 7

Clin f of MSK CP

Answer 7

Sudden of gradual onset- following exercise/strain/chest wall injury
Pain reproducable on palpation - worsening by deep inspiration

Question 8

Clin F of CP associated with GERD

Answer 8

Gradual onset central CP- burning - worsened by lying flat
Associated- nausea, vomiting

Question 9

Clin f of CP due to esophageal spasm

Answer 9

Sudden onset central CP relieved by GTN
Associated- dysphagia, heartburn and regurgitation