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Clin Med Cardio 1 > Chest Pain > Flashcards

Chest Pain Flashcards

1
Q

Myocardial Ischemia

A

Heart muscle not getting blood it needs

- Due to atherosclerosis, vasospasm, clot, tachy, anemia, hypoxic, LVH (more to perfuse)

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2
Q

Myocardial Ischemia sx

A

L CP can radiate to arm, jaw, epigastric

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3
Q

Types of Myocardial Ischemia

A
  • Angina pectoris
  • Unstable angina pectoris
  • Myocardial infarction
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4
Q

Angina Pectoris

A

Pressure, tightness, squeezing, heaviness, burning

  • Precipitated by some activity
  • 2-10 min
  • Treat w/ rest and/or nitro
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5
Q

Unstable angina pectoris

A

Same sx, a little stronger

  • Occurs w/ less activity
  • 10-20 min
  • Rest and/or nitro, takes longer to resolve
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6
Q

Myocardial Infarction

A

Most severe. Can occur anytime.

  • Up to 30 min
  • No relief (or mild relief) w/ nitro
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7
Q

Aortic Stenosis

A

Narrowing around aortic valve, flaps become calcified, smaller area for blood to get thru

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8
Q

Aortic Stenosis sx

A

Gradual onset, CP + DOE, dizziness, syncope

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9
Q

Aortic Stenosis dx

A

Echo: systolic murmur at 2nd RICS

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10
Q

Aortic Dissection pathophys + sx

A

Progressive tear in aorta

- Abrupt onset of tearing sharp anterior CP, back, shoulder blade, or abd pain

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11
Q

Aortic Dissection dx

A
  • Systolic murmur
  • Pericardial rub
  • Loss of peripheral pulses
  • Hypo or HTN
  • CT, MRA, CXR (wide mediastinum)
  • EKG (to r/o)
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12
Q

Pulmonary Embolism etiology + sx

A

Usually formed in deep veins of legs

- Abrupt onset CP + SOB, tachy, tachypnea, hypoTN, arrhythmia, syncope

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13
Q

Pulmonary Embolism dx

A

CXR, CT, D-dimer, EKG (S1Q3T3)

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14
Q

Pericarditis etiology + sx

A

Inflam of pericardial sac

  • Sharp pain, worse w/ breathing, coughing, moving
  • Improved w/ tripod position
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15
Q

Pericarditis dx

A
  • Hx and PE

- EKG, troponin

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16
Q

Pulmonary HTN sx

A

Progressive exertional CP + SOB, pressure, fatigue, syncope, edema

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17
Q

Pulmonary HTN dx

A

EKG, CXR (enlarged RV + pulm arteries), echo, R heart cath

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18
Q

Pneumonia sx

A

Onset is variable. Pleuritic pain, SOB, cough, sputum, fever, rales

19
Q

Pneumonia dx

A

CXR (infiltrates), CBC, sputum culture

20
Q

Pneumothorax

A

Collapsed lung

21
Q

Types of Pneumothorax

A

Spontaneous (Primary and Secondary), Tension, Traumatic

22
Q

Spontaneous Pneumothorax (etiology, sx, dx)

A
  • Sudden rupture of bleb
  • Sx: sudden onset pleuritic pain + SOB
  • Dx: decreased breath sounds, CXR
23
Q

Tension Pneumothorax (etiology, dx)

A
  • Air in pleural space

- Dx: absent breath sounds, CXR

24
Q

GERD is brought on by:

A

Acidic food, postprandial recumbency, alcohol, caffeine, stress

25
Q

GERD sx

A

Burning, tightness, pressure

  • Can last mins to hrs
  • Can radiate to upper or middle back
26
Q

GERD dx

A

pH, upper endoscopy, barium swallow

27
Q

Esophageal spasm

A

Contractions of esophagus, irregular, uncoordinated

28
Q

Esophageal spasm presentation

A

Quick (sec or min), pressure, tightness, burning, “food stuck feeling”

29
Q

Esophageal spasm dx

A

Esophageal manometry, barium swallow

30
Q

Esophageal spasm tx

A

Nitro will help (vasodilator)

31
Q

Esophageal rupture RF

A

DM, alcoholic, bulemic

32
Q

Esophageal rupture etiology + sx

A

Spontaneous perf of esophagus

- SEVERE PAIN, retrosternal pain, will get septic quickly

33
Q

Esophageal rupture dx

A

CXR, CT, upper endoscopy

34
Q

Esophageal rupture tx

A

Surg

35
Q

Gall Bladder Disease sx

A

RUQ pain referred to R shoulder

  • Worsening or intermittent pain
  • Burning, pressure
  • Worse after eating
36
Q

Gall Bladder Disease dx

A

US, lipase, LFT

37
Q

Musculoskeletal pain etiology

A

Main cause of CP
Usually occurs after activity
- Cervical disc disease, costochondritis, rib fx, trauma

38
Q

Musculoskeletal pain sx

A

Aching or sharp pain aggravated by movement (reproducible)

39
Q

Musculoskeletal pain dx

A
  • Hx and PE (reproducible)

- CXR (trauma)

40
Q

Psychiatric

A

Anxiety, brought on by stress, anger, panic

- Sharp, pressure, palpitations

41
Q

Herpes Zoster

A

Sharp, burning, dermatome distribution, vesicular rash (later)

42
Q

Evaluation of CP

A
  • EKG
  • Stabilize: MONA
  • Do they look sick?
  • Abnormal vitals?
  • Risk factors?
43
Q

What causes CP?

A
  • MI
  • Aortic stenosis
  • Aortic dissection
  • 5 P’s: pericarditis, pulm embolism, pulm HTN, pneumonia, pneumothorax
  • GERD
  • Esophageal spasm
  • Esophageal rupture
  • Gallbladder disease
  • Musculoskeletal
  • Herpes zoster
  • Psychiatric

Clin Med Cardio 1 (6 decks)

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