Session 9 - Chest Pain and Acute Coronary Syndromes Flashcards

1
Q

What are 2 main classifications of chest pain?

A

Cardiac

Pleuritic

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2
Q

What is visceral pain?

A

Typical cardiac pain from heart ischaemia or infarct

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3
Q

What is somatic pain?

A

Pleuritic chest pain

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4
Q

Where does visceral pain originate from?

A

Deeper structures via visceral afferent nerves

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5
Q

How does visceral pain feel like?

A

Dull, poorly localized but central

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6
Q

Where does somatic pain originate from?

A

Chest wall, pericardium and parietal pleura via somatic afferent nerves

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7
Q

How does somatic pain feel like?

A

Sharp, well localized, often non central

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8
Q

When is cardiac pain worsened?

A

Exercise and exertion

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9
Q

When is pleuritic pain worsened?

A

Chest movement like breathing in and coughing

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10
Q

What are 2 types of cardiac causes for chest pain?

A

Acute coronary syndromes

Pericarditis

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11
Q

What is pericarditis?

A

Inflammation of pericardium

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12
Q

What would you hear when examining patient with pericarditis?

A

Pericardial rub

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13
Q

What is ischaemic heart disease?

A

Insufficient blood supply to heart muscle due to atherosclerotic disease of coronary arteries

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14
Q

What are 4 types of ischaemic heart disease?

A

Stable angina
Unstable angina
NSTEMI
STEMI

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15
Q

What is the pathophysiology of acute coronary syndrome?

A

Atherosclerosis causes stable occlusion, plaque ruptures and forms a thrombus which suddenly increases occlusion, leading to ischaemia and potentially infarction and causes acute coronary syndromes

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16
Q

What determines the kind of acute coronary syndrome you get?

A

Severity of occlusion

17
Q

What is the difference between stable and unstable angina?

A

Angina not present during rest for stable angina

18
Q

What is the similarity in terms of ECG for stable and unstable angina?

A

ST depression

19
Q

What is a key differentiating factor between NSTEMI/STEMI and angina?

A

Troponin elevated in blood tests

20
Q

What’s the difference between NSTEMI and STEMI?

A

ST elevation for STEMI

Non ST elevation or ST depression for NSTEMI

21
Q

What are the 5 stages of ECG changes for STEMIs?

A

Acute - ST elevation
Hours - ST elevation, decreased R wave, Q wave begins
Day 1-2 - T wave inversion, Q wave deeper
Days later - ST normalizes, T wave inversion
Weeks later - ST and T normal, Q wave persists