Cardiac causes of chest pain 1. angina 2. AMI 3. pericarditis
case1 Cardiac cause A 50 years old patient presented with retro sternal chest pain which radiates to the left arm, jaw, neck 1.Exacerbation with ? 2.Relived with ? 3.Fever ? 4.Type of chest pain ? 5.Precipitating factors ? 6. male/ female ? Auscultatory finding Clinical diagnosis ? investigation
Clinical Spectrum of Acute Coronary Syndromes Stable angina Unstable angina Non-STE MI STE MI Evidence of necrosis None Positive Positive ST-segment elevation ST-segment depression and/or T-wave inversion ST-segment depression and/or T-wave inversion ECG early ECG late No Q No Q Q develops
Case 2 Respiratory cause A 30 years old patient presented with sudden onset right sided chest pain not radiates to the any other sites Predisposing factors ? Fever ? types of chest pain ? Other associated symptoms ? Auscultatory findings Breath sounds Clinical diagnosis ? investigation
case3 Vascular cause A 33 years old woman during her pregnancy presented with severe sudden onset severe chest pain which radiates to the back between the shoulder baldes Character of pain : tearing or ripping sensation Precipitating factors: Hypertension Connective tissue disorder Diagnosis ?
GI causes of chest pain 1. Esophageal reflexes 2. Esophageal rupture 3. pancreatitis 4, Peptic ulcer
case4 Gastrointestinal cause A 30 years old patient presented with retro sternal & epigastric burning sensation not radiates to any other sites. Pain most often exacerbated by alcohol, aspirin & foods Lying down , morning Pain is often relieved by antacids Clinical diagnosis ? Investigation ?
Musculoskeletal causes of chest pain 1. costochondritis 2. trauma
case5 Musculoskeletal cause A 38 years old patient presented with chest pain for last 20 days , worsened with Active and passive movement On examination : local tenderness swelling , redness present +/- Clinical diagnosis ? investigation