Angina STEMI NSTEMI Oesophagitis/oesophageal spasm Pulmonary infarction (embolus/right atrial spasm) Pneumothorax Dissecting thoracic aortic aneurysm Chest wall pain
- Angina is intermittent & N/STEMIs are continuous
2. Angina is relieved by rest or GTN cf. N/STEMIs
- No rise in troponin after 12 hours
2. No ST change on serial ECG
endoscopy
Worse on lying down
Worse on alcohol, NSAIDs, food.
Relieved by antacids
Cyanosis/hypoxia
sudden breathlessness
pleural rub
risk factor for DVT/PE
CTPA
Acute breathlessness
Pain in chest/one side of chest
Reduced breath sounds
Hyperresonance
EXPIRATORY CXR
‘tearing’ pain radiating to the back
absent/reduced peripheral pulses
Early diastolic murmur
widened mediastinum on CXR
loss of a single clear aortic lumen on CT or MRI
Tietzes syndrome (localised costochondritis)
pain/tenderness on twisting of the neck or thoracic cage.
pain (+- radiation) not releived by rest/nitrates
continuous
Elevated ST segment by 1mm in limb or 2mm in chest leads ON SERIAL ECGs
Depressed or normal ST or T segment
Raised troponin after 6 or 12 hours