Diff Dx - Referred Pain Patterns Flashcards Preview

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Flashcards in Diff Dx - Referred Pain Patterns Deck (5)
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1

Cardiac Chest Pain Pattern

  • Location: substernal/retrosternal (left or isolated midthoracic back pain in women) and aching in one or both upper arm
  • referral: neck, jaw, shoulder or arms (L arm), may have toothache, occasionally the abdomen
  • Description: viselike pressure, squeezing, heaviness, burning indigestion 
  • Intensity: mild to moderate
  • Duration: usually less then 10 min, no greater than 30 min (average 3-5)
  • Associated s/s: extreme fatigue, lethary or weakness in women, SOB (dyspnea), Nausea, Diaphoresis, anxiety, belching, heartburn, inhaling cold air (women), prolonged and repeated palpitations (women)
  • Relieved: rest/nitroglycerin or antacids (women)
  • Aggravating: exercise or physical exertion, cold weather or wind, heavy meals, emotional stress

2

Myocardial Infarction Pain Pattern

  • Location: substernal, anterior chest
  • Referral: may radiate like angina, frequently down both arms
  • Description: Burning, stabbing, viselike pressure, squeezing, heaviness
  • Intensity: severe
  • Duration: Usually at least 30 min, may last 1-2 hours
  • Associated s/s: none with silent MI, dizziness, feeling faint, n/v, pallor, diaphoresis, apprehension, fatigue, sudden weakness, dyspnea
  • Relieving: none, unrelieved by rest or NG taken every 5 min for 20 min
  • aggravating: not necessarily anything, may occur at rest or may follow emotional stress or physical exertion

3

Pericarditis Pain Pattern

  • Location: substernal or over the sternum, sometimes to the left of midline toward the cardiac apex
  • Referral:  neck, upper back, upper trap, left supraclavicular, down L arm, costal margins
  • description: more localized than MI pain
  • Intensity: moderate to severe
  • Duration: continuous
  • Associated s/s: medically determined
  • Relieving: sitting upright or leaning forward
  • Aggravating: deep breathing, L lateral side bend, trunk rotation, supine position

4

Aortic Aneurysm Pain Pattern

  • Location: anterior chest (thoracic) or abdomen (abdominal), thoracic area of back
  • Referral: pain may moe in the chest as dissection progresses, may extend into the beck, shoulders, interscapular area or lower back
  • Decription: knifelike, tearing (thoracic), dull ache in lower back or midabdominal L flank
  • Intensity: severe, excruciating
  • Duration: hours
  • Associated s/s: absent pulse, "abdominal heart beat", lower BP in one arm, pulsating mass
  • Relieving: none
  • Aggravating: supine position accentuates symptoms 

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