Acute ischaemic event
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This document discusses the pathogenesis of atherosclerosis and myocardial ischemia, as well as the presentation and treatment of acute myocardial infarction (AMI). It describes the development of atherosclerotic plaques, factors that increase oxygen demand and decrease supply leading to angina, and common symptoms of AMI such as chest pain and shortness of breath. The treatment principles of AMI focus on restoring blood flow to the heart and preventing complications. Medications like nitrates can help by reducing oxygen requirements and increasing supply to the heart.
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Pulmonary causes of chest pain
This document discusses various pulmonary causes of chest pain that are common reasons for emergency department visits. It outlines conditions like pulmonary embolism, pneumonia, bronchitis, lung cancer, and tuberculosis. Pulmonary embolism is described as resulting from a blood clot traveling from a deep vein thrombosis to the lungs. Symptoms include dyspnea, chest pain, and risk factors like immobilization. Pneumonia is an inflammatory lung condition caused by infection, with symptoms of cough, fever, and trouble breathing. Bronchitis involves inflammation of the bronchi and can be acute or chronic.
L4.approach to chest pain
This document provides information on evaluating and diagnosing chest pain. It begins by defining chest pain and noting that it is a common reason patients present for medical care. It then discusses the causes of chest pain and provides details on distinguishing ischemic from non-ischemic chest pain. Key factors for ischemic cardiac pain are discussed such as onset during exertion and relief with rest. The document provides guidance on evaluating a patient's chest pain by taking a thorough history addressing 10 specific points. Differential diagnoses for chest pain are also reviewed.
Chest pain
Chest pain can have many potential causes. A thorough history and physical exam are important to help determine the likely diagnosis and guide appropriate testing. Key aspects of the history include characteristics of the pain such as location, radiation, onset and nature. The physical exam focuses on identifying potential causes of the pain or associated symptoms. Initial tests may include an ECG, blood tests, chest x-ray and echocardiogram to help differentiate causes such as heart disease, pulmonary embolism, pneumonia or musculoskeletal issues. Further tests are guided by the initial findings.
Cardiac Versus Non Cardiac
There is no definitive way to differentiate between cardiac and non-cardiac chest pain without further evaluation. Severe chest pain should always be taken seriously and evaluated in an emergency department. Cardiac chest pain is caused by reduced blood flow and oxygen to the heart, which can lead to a heart attack without treatment. Non-cardiac chest pain can be due to structures in the chest like the esophagus or lungs. A medical history and physical exam can provide clues but further testing is often needed to determine the underlying cause of chest pain.
Chest pain ,chest pain 2014,
This document discusses the evaluation and diagnosis of chest pain. It notes that while chest pain can be caused by many life-threatening and non-life-threatening conditions, it is important for patients to seek medical evaluation due to the difficulty in distinguishing between causes without testing. A medical history and physical exam are important for evaluating potential causes, which can include conditions affecting the heart, lungs, chest wall, esophagus and abdomen. Based on the history and exam, targeted testing like EKGs, blood tests, imaging and other diagnostics may be used to determine the underlying cause.
Approach to chest pain
Chest pain can have many potential causes, including musculoskeletal issues (30-50%), gastrointestinal problems (10-20%), stable angina (10%), respiratory issues (5%), and acute coronary syndrome (ACS, 4%). Angina pain often radiates to areas supplied by the same spinal cord segments as the heart, such as the shoulders, arms, neck, jaw, and back. Radiation of chest pain to both arms indicates a stronger likelihood of a heart attack. The location and radiation pattern of angina is usually consistent over multiple occurrences.
Chest pain
Chest pain can have cardiac or non-cardiac causes. Cardiac causes include ischemic conditions like myocardial infarction and angina from coronary artery disease, as well as non-ischemic conditions like pericarditis and aortic aneurysm. Ischemic chest pain is often described as pressure or squeezing and may be exacerbated by exertion or stress. Non-cardiac causes include gastroesophageal issues, pulmonary problems, musculoskeletal strains, and shingles. Obtaining a thorough history of the pain characteristics, location, duration and accompanying symptoms is essential to determining the potential cause.
Chest pain 2009 ppt
This document discusses differentiating between cardiac and non-cardiac causes of chest pain. Cardiac causes include ischemic issues like myocardial infarction and non-ischemic problems like pericarditis. Non-cardiac causes range from gastrointestinal issues, pulmonary problems, musculoskeletal pain and even shingles. It is important to thoroughly assess patients experiencing chest pain to determine location, quality and accompanying symptoms to correctly identify potential life-threatening issues and provide appropriate intervention.
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Pulmonary causes of chest pain
This document discusses various pulmonary causes of chest pain that are common reasons for emergency department visits. It outlines conditions like pulmonary embolism, pneumonia, bronchitis, lung cancer, and tuberculosis. Pulmonary embolism is described as resulting from a blood clot traveling from a deep vein thrombosis to the lungs. Symptoms include dyspnea, chest pain, and risk factors like immobilization. Pneumonia is an inflammatory lung condition caused by infection, with symptoms of cough, fever, and trouble breathing. Bronchitis involves inflammation of the bronchi and can be acute or chronic.
L4.approach to chest pain
This document provides information on evaluating and diagnosing chest pain. It begins by defining chest pain and noting that it is a common reason patients present for medical care. It then discusses the causes of chest pain and provides details on distinguishing ischemic from non-ischemic chest pain. Key factors for ischemic cardiac pain are discussed such as onset during exertion and relief with rest. The document provides guidance on evaluating a patient's chest pain by taking a thorough history addressing 10 specific points. Differential diagnoses for chest pain are also reviewed.
Chest pain
Chest pain can have many potential causes. A thorough history and physical exam are important to help determine the likely diagnosis and guide appropriate testing. Key aspects of the history include characteristics of the pain such as location, radiation, onset and nature. The physical exam focuses on identifying potential causes of the pain or associated symptoms. Initial tests may include an ECG, blood tests, chest x-ray and echocardiogram to help differentiate causes such as heart disease, pulmonary embolism, pneumonia or musculoskeletal issues. Further tests are guided by the initial findings.
Cardiac Versus Non Cardiac
There is no definitive way to differentiate between cardiac and non-cardiac chest pain without further evaluation. Severe chest pain should always be taken seriously and evaluated in an emergency department. Cardiac chest pain is caused by reduced blood flow and oxygen to the heart, which can lead to a heart attack without treatment. Non-cardiac chest pain can be due to structures in the chest like the esophagus or lungs. A medical history and physical exam can provide clues but further testing is often needed to determine the underlying cause of chest pain.
Chest pain ,chest pain 2014,
This document discusses the evaluation and diagnosis of chest pain. It notes that while chest pain can be caused by many life-threatening and non-life-threatening conditions, it is important for patients to seek medical evaluation due to the difficulty in distinguishing between causes without testing. A medical history and physical exam are important for evaluating potential causes, which can include conditions affecting the heart, lungs, chest wall, esophagus and abdomen. Based on the history and exam, targeted testing like EKGs, blood tests, imaging and other diagnostics may be used to determine the underlying cause.
Approach to chest pain
Chest pain can have many potential causes, including musculoskeletal issues (30-50%), gastrointestinal problems (10-20%), stable angina (10%), respiratory issues (5%), and acute coronary syndrome (ACS, 4%). Angina pain often radiates to areas supplied by the same spinal cord segments as the heart, such as the shoulders, arms, neck, jaw, and back. Radiation of chest pain to both arms indicates a stronger likelihood of a heart attack. The location and radiation pattern of angina is usually consistent over multiple occurrences.
Chest pain
Chest pain can have cardiac or non-cardiac causes. Cardiac causes include ischemic conditions like myocardial infarction and angina from coronary artery disease, as well as non-ischemic conditions like pericarditis and aortic aneurysm. Ischemic chest pain is often described as pressure or squeezing and may be exacerbated by exertion or stress. Non-cardiac causes include gastroesophageal issues, pulmonary problems, musculoskeletal strains, and shingles. Obtaining a thorough history of the pain characteristics, location, duration and accompanying symptoms is essential to determining the potential cause.
Chest pain 2009 ppt
This document discusses differentiating between cardiac and non-cardiac causes of chest pain. Cardiac causes include ischemic issues like myocardial infarction and non-ischemic problems like pericarditis. Non-cardiac causes range from gastrointestinal issues, pulmonary problems, musculoskeletal pain and even shingles. It is important to thoroughly assess patients experiencing chest pain to determine location, quality and accompanying symptoms to correctly identify potential life-threatening issues and provide appropriate intervention.
How to approach a patient with chest pain
History, Examination and Investigations of patient with chest pain and the differentials you can come up with.
Approach to chest pain
This document provides guidance on evaluating and treating chest pain. It outlines many potential causes of chest pain including cardiac, pulmonary, gastrointestinal and musculoskeletal issues. For serious potential causes like myocardial ischemia, pericarditis or aortic dissection, the document describes relevant history, examination findings and initial investigations. It emphasizes doing an ECG, reviewing risk factors and considering stress testing to evaluate for cardiac ischemia as a common cause of chest pain. The document also reviews palpitations as an unrelated symptom and potential cardiac and non-cardiac causes.
Chest pain algorithm
This document provides guidance on evaluating and diagnosing patients presenting with chest pain. It indicates that for patients with chest pain and cardiac risk factors, an electrocardiogram (ECG) and troponin levels should be checked. If the ECG or troponin levels are abnormal, the patient is considered a cardiac emergency and needs further assessment. If suspicion of pulmonary embolism exists, a Wells score and D-dimer test or CT scan can help diagnose pulmonary embolism. Other potential causes of chest pain discussed include pneumonia, panic disorder, chest wall pain, and gastrointestinal pathology. Characteristics of specific cardiac-related chest pains like angina, myocardial infarction, and pericarditis are also summarized.
Chest pain- not everything is MI
a short ppt for Casualty group discussion- not all patients presenting with Chest pain are affceted with Cardiac ailments.
prepared and presented in 2008
Chest pain dr kmh
Central chest pain can be caused by cardiac issues like angina or myocardial infarction, or non-cardiac issues like pulmonary embolism or esophageal disorders. A thorough history of the characteristics of the pain, including location, duration, aggravating/relieving factors, and associated symptoms can help determine the underlying cause. Key factors that help differentiate cardiac from non-cardiac chest pain include relationship to exertion and response to nitroglycerin.
Angina pectoris
Angina pectoris is chest pain or discomfort that occurs when the heart muscle does not get enough oxygen. It is usually caused by narrowed coronary arteries that cannot supply enough blood and oxygen to meet increased demands. The symptoms include chest pain or pressure that can radiate to the arms, neck or jaw, brought on by activity or stress, and relieved by rest. Diagnosis involves evaluating symptoms, risk factors, and electrocardiogram changes during episodes to confirm ischemia as the cause of symptoms.
Buerger allens exercises
Buerger's disease is an inflammation of the blood vessels in the arms and legs that can lead to damage of the skin tissues and gangrene. It predominantly affects Asian and Middle Eastern male smokers aged 40-45. The exact cause is unknown but tobacco use is a major risk factor. Symptoms include pain, numbness, skin sores and color changes in the extremities. Diagnosis involves blood tests and imaging tests. The only effective treatment is complete abstinence from tobacco, while exercises like Buerger's can help improve circulation.
Chest pain
This document provides an overview of the approach to evaluating and diagnosing chest pain. It discusses how chest pain can be caused by conditions affecting the heart, lungs, esophagus and other organs. The evaluation involves taking a detailed history of the quality, location, timing and relieving/worsening factors of the pain and performing a physical exam. Key investigations include electrocardiography, chest x-ray, cardiac biomarkers and imaging tests like CT angiography to identify potential cardiac, pulmonary, aortic or gastrointestinal causes of the chest pain. A systematic approach considering the history, exam and test results is needed to diagnose the underlying condition causing the chest pain.
Pericarditis
Pericarditis is the inflammation of the pericardium, a thin, two-layered sac that surrounds your heart. The layers have a small amount of fluid between them to prevent friction when the heart beats. When the layers are inflamed, it can result in chest pain.
L 6.approach to chest pain
Chest pain is one of the most common reasons patients present for medical attention and can be challenging to diagnose. A thorough history and physical exam is important to determine the cause, which could include ischemic heart disease, pulmonary issues, gastrointestinal problems, or other non-cardiac causes. The characteristics of cardiac chest pain often involve pain that builds up over minutes rather than seconds, may radiate to the arm or jaw, and is commonly accompanied by symptoms like sweating, nausea, and shortness of breath. Proper diagnosis requires considering risk factors, symptoms, and test results such as ECG, cardiac enzymes, stress testing, and imaging to correctly identify the source and manage appropriately.
Evaluation of chest pain
This document discusses various causes of acute chest pain that can pose an immediate threat to life, including acute coronary syndrome, aortic dissection, pulmonary embolism, tension pneumothorax, pericardial tamponade, and mediastinitis. It provides details on the presentation, diagnostic workup, and initial management of these conditions. Common initial steps include electrocardiography, cardiac biomarkers, imaging tests like CT scans, and treating any life-threatening diagnoses emergently through interventions such as fibrinolysis, anticoagulation, or procedures to relieve tamponade. Conditions requiring ICU admission generally include those with hemodynamic instability or respiratory distress.
Chest Pain Management - Desun Hospital Health Insights
Desun Hospital Health Insights : Chest pain management by Saikat Banerjee, Sr. Deputy Manager, DESUN Hospital & Heart Institute.
L 6.approach to chest pain
This document provides guidance on evaluating and diagnosing chest pain. It begins by defining chest pain and noting that it is a common reason patients present for medical care. A list of 10 questions for history taking on chest pain is then provided related to onset, location, character, duration, radiation, aggravating/relieving factors, tenderness, associated symptoms and severity. Causes of chest pain are discussed, distinguishing ischemic causes like angina and myocardial infarction from non-ischemic causes. Characteristics of cardiac pain like gradual onset and associated sweating or nausea are outlined. Differential diagnoses including aortic dissection, pulmonary embolism, pericarditis and esophageal spasm are also reviewed. An approach to diagnosis
Chest pain
This document provides guidance on evaluating and diagnosing the cause of chest pain. It notes that the majority of chest pain is non-cardiac in origin but can be disabling. A thorough history, physical exam, ECG and imaging can identify most causes, including life-threatening ones like myocardial infarction that require immediate treatment. The description of chest pain symptoms and related factors can provide clues to potential etiologies such as cardiac, pulmonary, gastrointestinal or musculoskeletal origin.
Red Flag Chest Pain
This document lists potential serious medical conditions that can present with thoracic spine or rib problems, along with associated red flags from patient history and physical exam. It identifies red flags for conditions like myocardial infarction, angina, pericarditis, spinal fracture, pneumothorax, pneumonia, pleurisy, pulmonary embolism, and chest pain without cardiac causes. Red flags include things like certain types of chest pain, dyspnea, risk factors, fever, cough, and physical exam findings related to each condition. Differentiating these conditions is important for guiding appropriate medical management.
L 6.approach to chest pain
This document discusses the approach to evaluating chest pain. It begins by defining chest pain and noting that it is a common reason patients present for medical care. The causes of chest pain are then reviewed, with 14% being cardiac in origin. Key aspects of evaluating chest pain are discussed, including asking the patient 10 questions about the characteristics of the pain and differentiating ischemic from non-ischemic chest pain. Features that help determine if chest pain is cardiac-related are outlined. The differential diagnosis of chest pain is also reviewed, noting potential cardiac, pulmonary, gastrointestinal and other causes. Diagnostic testing is then discussed to help identify the underlying reason for a patient's chest pain.
Approach to chest pain
This document discusses an approach to evaluating and diagnosing the cause of chest pain. It begins by outlining the importance of taking a thorough history, including details on location, radiation, timing, aggravating/relieving factors, and associated symptoms. Physical exam findings that may provide clues are also reviewed. Key tests for evaluation include ECG, cardiac biomarkers, echocardiogram, and imaging studies. Differential diagnoses discussed include angina, aortic dissection, pulmonary embolism, gastroesophageal causes, musculoskeletal causes, and psychological factors. Diagnosis involves synthesizing all available clinical information.
Differential Dx Chest Pain
The document discusses the differential diagnosis of chest pain. It notes that the chest x-ray and history are the most important tests to evaluate non-cardiac chest pain. The history requires a meticulous examination of all relevant details. Many life-threatening and non-life threatening potential causes of chest pain are outlined, including cardiac, pulmonary, gastrointestinal, musculoskeletal, psychiatric, and neurological conditions. Thoracic outlet syndromes are given a detailed differential diagnosis. The evaluation of chest pain is emphasized to be complex, requiring a defined diagnosis beyond simply ruling out heart attack.
Chest pain differential diagnosis
1. Acute coronary syndrome can present with substernal chest pressure, pain radiating to the shoulders, or pain with exertion. ECG may show ST elevations or new left bundle branch block indicating AMI. Troponin and CK-MB elevations are needed to diagnose AMI.
2. Aortic dissection often presents with sudden, severe chest pain and may be suggested on ECG by discrepancies in blood pressure between arms or signs of ischemia. Chest X-ray may show a widened mediastinum.
3. Pulmonary embolism presentations can vary widely but often include dyspnea. ECG may show signs of right heart strain. Most chest X-rays are normal but some show
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Heart failure caused by restrictive cardiomyopathy. role of integrated diagno...
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Restrictive cardiomyopathy
Restrictive cardiomyopathy is characterized by impaired ventricular filling during diastole due to a primary decrease in ventricular compliance. The myocardium is partially infiltrated by noncontractile tissue or extracellular material, impairing the heart's ability to dilate. Causes include amyloidosis, sarcoidosis, and idiopathic restrictive cardiomyopathy. On morphology, the ventricles are normally or slightly enlarged while the cavities are not dilated. The myocardium is firm and noncompliant, and the atria show biatrial dilation. Patients experience signs and symptoms of congestive heart failure with prominent right-sided features.
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How to approach a patient with chest pain
History, Examination and Investigations of patient with chest pain and the differentials you can come up with.
Approach to chest pain
This document provides guidance on evaluating and treating chest pain. It outlines many potential causes of chest pain including cardiac, pulmonary, gastrointestinal and musculoskeletal issues. For serious potential causes like myocardial ischemia, pericarditis or aortic dissection, the document describes relevant history, examination findings and initial investigations. It emphasizes doing an ECG, reviewing risk factors and considering stress testing to evaluate for cardiac ischemia as a common cause of chest pain. The document also reviews palpitations as an unrelated symptom and potential cardiac and non-cardiac causes.
Chest pain algorithm
This document provides guidance on evaluating and diagnosing patients presenting with chest pain. It indicates that for patients with chest pain and cardiac risk factors, an electrocardiogram (ECG) and troponin levels should be checked. If the ECG or troponin levels are abnormal, the patient is considered a cardiac emergency and needs further assessment. If suspicion of pulmonary embolism exists, a Wells score and D-dimer test or CT scan can help diagnose pulmonary embolism. Other potential causes of chest pain discussed include pneumonia, panic disorder, chest wall pain, and gastrointestinal pathology. Characteristics of specific cardiac-related chest pains like angina, myocardial infarction, and pericarditis are also summarized.
Chest pain- not everything is MI
a short ppt for Casualty group discussion- not all patients presenting with Chest pain are affceted with Cardiac ailments.
prepared and presented in 2008
Chest pain dr kmh
Central chest pain can be caused by cardiac issues like angina or myocardial infarction, or non-cardiac issues like pulmonary embolism or esophageal disorders. A thorough history of the characteristics of the pain, including location, duration, aggravating/relieving factors, and associated symptoms can help determine the underlying cause. Key factors that help differentiate cardiac from non-cardiac chest pain include relationship to exertion and response to nitroglycerin.
Angina pectoris
Angina pectoris is chest pain or discomfort that occurs when the heart muscle does not get enough oxygen. It is usually caused by narrowed coronary arteries that cannot supply enough blood and oxygen to meet increased demands. The symptoms include chest pain or pressure that can radiate to the arms, neck or jaw, brought on by activity or stress, and relieved by rest. Diagnosis involves evaluating symptoms, risk factors, and electrocardiogram changes during episodes to confirm ischemia as the cause of symptoms.
Buerger allens exercises
Buerger's disease is an inflammation of the blood vessels in the arms and legs that can lead to damage of the skin tissues and gangrene. It predominantly affects Asian and Middle Eastern male smokers aged 40-45. The exact cause is unknown but tobacco use is a major risk factor. Symptoms include pain, numbness, skin sores and color changes in the extremities. Diagnosis involves blood tests and imaging tests. The only effective treatment is complete abstinence from tobacco, while exercises like Buerger's can help improve circulation.
Chest pain
This document provides an overview of the approach to evaluating and diagnosing chest pain. It discusses how chest pain can be caused by conditions affecting the heart, lungs, esophagus and other organs. The evaluation involves taking a detailed history of the quality, location, timing and relieving/worsening factors of the pain and performing a physical exam. Key investigations include electrocardiography, chest x-ray, cardiac biomarkers and imaging tests like CT angiography to identify potential cardiac, pulmonary, aortic or gastrointestinal causes of the chest pain. A systematic approach considering the history, exam and test results is needed to diagnose the underlying condition causing the chest pain.
Pericarditis
Pericarditis is the inflammation of the pericardium, a thin, two-layered sac that surrounds your heart. The layers have a small amount of fluid between them to prevent friction when the heart beats. When the layers are inflamed, it can result in chest pain.
L 6.approach to chest pain
Chest pain is one of the most common reasons patients present for medical attention and can be challenging to diagnose. A thorough history and physical exam is important to determine the cause, which could include ischemic heart disease, pulmonary issues, gastrointestinal problems, or other non-cardiac causes. The characteristics of cardiac chest pain often involve pain that builds up over minutes rather than seconds, may radiate to the arm or jaw, and is commonly accompanied by symptoms like sweating, nausea, and shortness of breath. Proper diagnosis requires considering risk factors, symptoms, and test results such as ECG, cardiac enzymes, stress testing, and imaging to correctly identify the source and manage appropriately.
Evaluation of chest pain
This document discusses various causes of acute chest pain that can pose an immediate threat to life, including acute coronary syndrome, aortic dissection, pulmonary embolism, tension pneumothorax, pericardial tamponade, and mediastinitis. It provides details on the presentation, diagnostic workup, and initial management of these conditions. Common initial steps include electrocardiography, cardiac biomarkers, imaging tests like CT scans, and treating any life-threatening diagnoses emergently through interventions such as fibrinolysis, anticoagulation, or procedures to relieve tamponade. Conditions requiring ICU admission generally include those with hemodynamic instability or respiratory distress.
Chest Pain Management - Desun Hospital Health Insights
Desun Hospital Health Insights : Chest pain management by Saikat Banerjee, Sr. Deputy Manager, DESUN Hospital & Heart Institute.
L 6.approach to chest pain
This document provides guidance on evaluating and diagnosing chest pain. It begins by defining chest pain and noting that it is a common reason patients present for medical care. A list of 10 questions for history taking on chest pain is then provided related to onset, location, character, duration, radiation, aggravating/relieving factors, tenderness, associated symptoms and severity. Causes of chest pain are discussed, distinguishing ischemic causes like angina and myocardial infarction from non-ischemic causes. Characteristics of cardiac pain like gradual onset and associated sweating or nausea are outlined. Differential diagnoses including aortic dissection, pulmonary embolism, pericarditis and esophageal spasm are also reviewed. An approach to diagnosis
Chest pain
This document provides guidance on evaluating and diagnosing the cause of chest pain. It notes that the majority of chest pain is non-cardiac in origin but can be disabling. A thorough history, physical exam, ECG and imaging can identify most causes, including life-threatening ones like myocardial infarction that require immediate treatment. The description of chest pain symptoms and related factors can provide clues to potential etiologies such as cardiac, pulmonary, gastrointestinal or musculoskeletal origin.
Red Flag Chest Pain
This document lists potential serious medical conditions that can present with thoracic spine or rib problems, along with associated red flags from patient history and physical exam. It identifies red flags for conditions like myocardial infarction, angina, pericarditis, spinal fracture, pneumothorax, pneumonia, pleurisy, pulmonary embolism, and chest pain without cardiac causes. Red flags include things like certain types of chest pain, dyspnea, risk factors, fever, cough, and physical exam findings related to each condition. Differentiating these conditions is important for guiding appropriate medical management.
L 6.approach to chest pain
This document discusses the approach to evaluating chest pain. It begins by defining chest pain and noting that it is a common reason patients present for medical care. The causes of chest pain are then reviewed, with 14% being cardiac in origin. Key aspects of evaluating chest pain are discussed, including asking the patient 10 questions about the characteristics of the pain and differentiating ischemic from non-ischemic chest pain. Features that help determine if chest pain is cardiac-related are outlined. The differential diagnosis of chest pain is also reviewed, noting potential cardiac, pulmonary, gastrointestinal and other causes. Diagnostic testing is then discussed to help identify the underlying reason for a patient's chest pain.
Approach to chest pain
This document discusses an approach to evaluating and diagnosing the cause of chest pain. It begins by outlining the importance of taking a thorough history, including details on location, radiation, timing, aggravating/relieving factors, and associated symptoms. Physical exam findings that may provide clues are also reviewed. Key tests for evaluation include ECG, cardiac biomarkers, echocardiogram, and imaging studies. Differential diagnoses discussed include angina, aortic dissection, pulmonary embolism, gastroesophageal causes, musculoskeletal causes, and psychological factors. Diagnosis involves synthesizing all available clinical information.
Differential Dx Chest Pain
The document discusses the differential diagnosis of chest pain. It notes that the chest x-ray and history are the most important tests to evaluate non-cardiac chest pain. The history requires a meticulous examination of all relevant details. Many life-threatening and non-life threatening potential causes of chest pain are outlined, including cardiac, pulmonary, gastrointestinal, musculoskeletal, psychiatric, and neurological conditions. Thoracic outlet syndromes are given a detailed differential diagnosis. The evaluation of chest pain is emphasized to be complex, requiring a defined diagnosis beyond simply ruling out heart attack.
Chest pain differential diagnosis
1. Acute coronary syndrome can present with substernal chest pressure, pain radiating to the shoulders, or pain with exertion. ECG may show ST elevations or new left bundle branch block indicating AMI. Troponin and CK-MB elevations are needed to diagnose AMI.
2. Aortic dissection often presents with sudden, severe chest pain and may be suggested on ECG by discrepancies in blood pressure between arms or signs of ischemia. Chest X-ray may show a widened mediastinum.
3. Pulmonary embolism presentations can vary widely but often include dyspnea. ECG may show signs of right heart strain. Most chest X-rays are normal but some show
Clinical examination peripheral vascular disease
This document provides an overview of peripheral vascular diseases (PVD), including definitions, pathophysiology, causes, clinical examination, investigations, management, and specific conditions like atherosclerosis, thromboangitis obliterans (Buerger's disease), Raynaud's disease, acute arterial disease, and gangrene. It describes the clinical features, risk factors, and pathology of different types of PVD and provides guidance on evaluating patients through history, physical examination, tests, and setting treatment plans which may involve lifestyle changes, medications, procedures like angioplasty, or surgeries such as bypass or amputation.
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Chest Pain Management - Desun Hospital Health Insights
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Restrictive cardiomyopathy is characterized by impaired ventricular filling during diastole due to a primary decrease in ventricular compliance. The myocardium is partially infiltrated by noncontractile tissue or extracellular material, impairing the heart's ability to dilate. Causes include amyloidosis, sarcoidosis, and idiopathic restrictive cardiomyopathy. On morphology, the ventricles are normally or slightly enlarged while the cavities are not dilated. The myocardium is firm and noncompliant, and the atria show biatrial dilation. Patients experience signs and symptoms of congestive heart failure with prominent right-sided features.
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This document discusses different types of cardiomyopathies including their classification, etiology, and treatment. It focuses on dilated cardiomyopathy (DCM), providing details on its classification, causes, clinical presentation, diagnosis, and management. It also discusses other forms of cardiomyopathy such as hypertrophic cardiomyopathy (HCM), describing its characteristic left ventricular hypertrophy and outflow tract obstruction. The document aims to comprehensively classify and describe different cardiomyopathies for medical professionals.
Rheumatic Fever by Adnan Bhutto
Rheumatic fever is caused by a delayed immune response to group A beta-hemolytic streptococcal infection. It primarily affects the heart, joints, subcutaneous tissue, and brain. It is more common in developing countries and affects children between 5-15 years old. Symptoms include arthritis, carditis, Sydenham's chorea, subcutaneous nodules, and erythema marginatum. Diagnosis is based on modified Jones criteria and treatment involves antibiotics, anti-inflammatories, and long-term prevention of recurrent infections.
Rheumatic fever
1) Acute rheumatic fever is a non-suppurative sequelae that occurs 1-3 weeks after a group A streptococcal infection, causing inflammatory damage to the heart, joints, skin and brain.
2) It most commonly affects children ages 5-15 and is more prevalent in developing countries.
3) The pathogenesis involves an autoimmune response triggered by antibodies produced against the streptococcal infection. This causes inflammatory lesions and damage to tissues.
4) Diagnosis is based on modified Jones criteria which requires evidence of prior streptococcal infection plus either two major clinical manifestations or one major and two minor manifestations. Treatment involves antibiotics to treat the initial infection along with anti-inflammatory drugs
Infective endocarditis
A 32-year-old man with a history of rheumatic heart disease and mitral valve repair presented with fever, chills, myalgia and shortness of breath. Examination revealed signs of infective endocarditis including a heart murmur, splenomegaly, splinter hemorrhages and skin lesions. Blood cultures and echocardiography were performed to diagnose infective endocarditis and determine the causative organism and extent of valve involvement. The document discusses the pathogenesis, clinical features, diagnostic criteria and treatment guidelines for infective endocarditis based on the infecting organism and type of valve affected.
Cardiomyopathy
Cardiomyopathy (KAR-de-o-mi-OP-ah-thee) refers to diseases of the heart muscle. These diseases have many causes, signs and symptoms, and treatments.
In cardiomyopathy, the heart muscle becomes enlarged, thick, or rigid. In rare cases, the muscle tissue in the heart is replaced with scar tissue.
As cardiomyopathy worsens, the heart becomes weaker. It's less able to pump blood through the body and maintain a normal electrical rhythm. This can lead toheart failure or irregular heartbeats called arrhythmias (ah-RITH-me-ahs). In turn, heart failure can cause fluid to build up in the lungs, ankles, feet, legs, or abdomen.
The weakening of the heart also can cause other complications, such as heart valve problems.
OverviewThe main types of cardiomyopathy are:
Dilated cardiomyopathy
Hypertrophic (hi-per-TROF-ik) cardiomyopathy
Restrictive cardiomyopathy
Arrhythmogenic (ah-rith-mo-JEN-ik) right ventricular dysplasia
(dis-PLA-ze-ah)
Other types of cardiomyopathy sometimes are referred to as "unclassified cardiomyopathy."
Cardiomyopathy can be acquired or inherited. "Acquired" means you aren't born with the disease, but you develop it due to another disease, condition, or factor. "Inherited" means your parents passed the gene for the disease on to you. Many times, the cause of cardiomyopathy isn't known.
Cardiomyopathy can affect people of all ages. However, people in certain age groups are more likely to have certain types of cardiomyopathy. This article focuses on cardiomyopathy in adults.
OutlookSome people who have cardiomyopathy have no signs or symptoms and need no treatment. For other people, the disease develops quickly, symptoms are severe, and serious complications occur.
Treatments for cardiomyopathy include lifestyle changes, medicines, surgery, implanted devices to correct arrhythmias, and a nonsurgical procedure. These treatments can control symptoms, reduce complications, and stop the disease from getting worse.
National Heart Lung and Blood Institute
Infective endocarditis
1. Infective endocarditis is an infection of the heart valves or endocardium. It can affect native or prosthetic valves.
2. Risk factors include artificial heart valves, congenital heart defects, and intravenous drug use. Common causative organisms are staphylococci and streptococci.
3. Symptoms include fever, chills, weight loss, and heart failure. Signs include heart murmurs, petechiae, splinter hemorrhages, and Osler's nodes. Diagnosis involves blood cultures and echocardiography. Treatment is intravenous antibiotics for 4-6 weeks along with possible surgery.
2015 ESC Guidelines on Infective Endocarditis ppt. by Dr Abhishek Rathore MD
The document summarizes guidelines for the management of infective endocarditis (IE). It recommends an endocarditis team approach in a reference center for complicated IE cases. It emphasizes the importance of early diagnosis, antibiotic therapy, and consideration of early surgery. It also discusses new recommendations for specific IE situations, antibiotic prophylaxis, surgical management, and the roles of imaging and multidisciplinary care in IE management.
Infective endocarditis
Infective endocarditis is a microbial infection of the heart valves or endocardium. It typically involves the valves and can be caused by many pathogens. The most common causes are streptococci, staphylococci, and enterococci. Untreated infective endocarditis has a high fatality rate. The pathogenesis involves endothelial damage, platelet-fibrin deposition forming nonbacterial thrombotic endocarditis (NBTE), and microbial colonization of the NBTE resulting in bacterial vegetations. Local effects include valvular damage, abscesses, fistulae, and conduction abnormalities. Distant effects occur via septic emboli that can lodge in organs like the brain, lungs,
cardiomyopathy
CARDIOMYOPATHY IS A SPECIAL ENTITY IN CARDIOLOGY.THIS WAS MY SEMINAR IN FIRST YEAR.HAVE A LOOK AFTER IT.
Cardiomyopathy
Cardiomyopathy is a disease of the heart muscle that makes it difficult for the heart to pump blood effectively. There are three main types: dilated cardiomyopathy causes the heart chambers to enlarge; hypertrophic cardiomyopathy results in abnormal thickening of the heart muscle; and restrictive cardiomyopathy occurs when heart muscle is replaced with scar tissue causing stiffness. Symptoms include fatigue, shortness of breath, and heart failure. Treatment involves medications, surgically implanted devices, and possibly heart transplant for severe cases.
Cardiomyopathies
Dilated cardiomyopathy is the most common type of cardiomyopathy and is characterized by left ventricular dilation and systolic dysfunction. Causes include genetic factors in 20-50% of cases as well as myocarditis, alcohol toxicity, and peripartum cardiomyopathy. Hypertrophic cardiomyopathy is caused by mutations in sarcomeric genes and is characterized by asymmetric hypertrophy of the ventricular septum. Restrictive cardiomyopathy results in stiff ventricles with impaired diastolic filling and is associated with conditions causing fibrosis like radiation, amyloidosis, and sarcoidosis. The main types of cardiomyopathy are dilated, hypertrophic, restrictive, and arrhythmogenic right ventricular cardiomyopathy.
Cardiomyopathy
Cardiomyopathy is a disease of the heart muscle that weakens the heart's ability to pump blood effectively. The main types are dilated, hypertrophic, and restrictive cardiomyopathy. Dilated cardiomyopathy is the most common type and causes the heart chambers to enlarge over time. Treatment involves managing symptoms and risk factors with medications, lifestyle changes, surgery such as implantable devices or transplant, and treating any underlying causes. A heart transplant may be an option for severe cases but carries risks of organ rejection, infection, and side effects of immunosuppressant drugs.
Ischemic Heart Disease
This document discusses ischemic heart disease and coronary artery disease. Coronary artery disease is caused by atherosclerosis which develops due to risk factors like smoking, high blood pressure, high cholesterol, and diabetes. Clinical presentations include stable angina, unstable angina, non-ST elevation myocardial infarction, and ST elevation myocardial infarction. Treatment involves lifestyle modifications, medications like antiplatelets, anticoagulants, and statins, as well as procedures like percutaneous coronary intervention and coronary artery bypass grafting.
Myocardial Infarction
This document summarizes the pathophysiology, risk factors, clinical manifestations, diagnostic evaluations, assessment factors, possible nursing diagnoses, care plan, and interventions for myocardial infarction. It discusses how myocardial infarction occurs due to a blockage or reduced blood flow to the heart muscle that damages the heart tissue. Common risk factors include age, gender, high blood pressure, smoking, and oral contraceptive use. Signs and symptoms include chest pain, shortness of breath, nausea, and more. Diagnostic tests include electrocardiograms, echocardiograms, and serum enzyme and isoenzyme levels. Nursing focuses on pain relief, preventing further damage, maintaining perfusion and respiratory function through interventions like oxygen, medications, and education.
Acute Myocardial infarction
This document provides an overview of acute myocardial infarction (MI), also known as a heart attack. It discusses the definition, causes, risk factors, pathogenesis, classification, diagnosis and management of MI. The diagnosis involves taking a patient history, examining signs and symptoms, electrocardiography, serum analysis and echocardiography. Management is staged and involves pre-hospital, emergency department and post-discharge care, with a focus on reperfusing the blocked artery as quickly as possible, such as through percutaneous coronary intervention or thrombolytic therapy. The goal is to correctly identify the type of MI, treat the patient according to guidelines and manage any complications.
Heart attack ppt
Myocardial infarction, also known as a heart attack, occurs when blood flow to the heart is suddenly blocked, reducing oxygen levels and causing the heart to stop working normally. It is the leading cause of death in the United States, with over 1.5 million Americans experiencing heart attacks each year. Common symptoms include chest pain, shortness of breath, nausea, and fainting. Major risk factors include smoking, high blood pressure, diabetes, high cholesterol, obesity, and heavy alcohol use. Treatment focuses on restoring blood flow and oxygen to the heart through medications and fluids administered intravenously while monitoring the patient in the hospital.
Myocardial infarction
Myocardial infarction, or a heart attack, occurs when blood flow to the heart is blocked, usually by a clot, damaging heart muscle. It can cause chest pain and is diagnosed through electrocardiograms, cardiac enzyme levels, and other tests. Over time, the damaged heart muscle is replaced with scar tissue through a healing process. Complications can include arrhythmias, heart failure, blood clots, or rupture of the heart muscle. Treatment involves lifestyle changes, medications, or procedures like stenting or bypass surgery to restore blood flow.
rheumatic fever
Rheumatic fever is an inflammatory disease that can affect the heart, joints, blood vessels, and nervous system following a streptococcal infection of the throat or skin. It is most common in children ages 5-15. Symptoms may include fever, joint pain and swelling, involuntary movements (chorea), and heart valve damage. Diagnosis is based on symptoms occurring after a streptococcal infection along with findings on physical exam and tests like echocardiogram and electrocardiogram. Treatment focuses on antibiotics to prevent recurrence as well as medications for symptoms like joint pain, heart failure, and chorea. Damage to heart valves may require long-term antibiotics or valve surgery.
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2015 ESC Guidelines on Infective Endocarditis ppt. by Dr Abhishek Rathore MD
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Chest Discomforts.pptx
Chest pain can be cardiac or non-cardiac in origin. Cardiac causes include myocardial ischemia, angina, and acute coronary syndromes which present with characteristic dull, squeezing pain in the center of the chest that may radiate to the arms and is exacerbated by exertion. Non-cardiac causes include pulmonary embolism, pneumonia, gallbladder disease and musculoskeletal disorders which typically cause localized, sharp pains. A thorough history and physical exam is needed to differentiate cardiac from non-cardiac chest pain and determine appropriate treatment or need for further testing.
Approach chest pain & acs
The document provides information on evaluating and managing patients presenting with chest pain and acute coronary syndrome. It discusses how to take a clinical history to determine the nature and cause of chest pain. Differential diagnoses are provided for cardiac and non-cardiac causes. Acute coronary syndrome is described as encompassing unstable angina, NSTEMI, and STEMI, which present with chest pain at rest or minimal exertion due to plaque rupture or erosion in coronary arteries. Immediate management in the first 12 hours and long-term management are outlined.
chest pain,Davidson,cardiac chest pain,non cardiac pain
This document defines and discusses chest pain, including its potential cardiac and non-cardiac causes. It outlines how to evaluate chest pain by determining if it could be due to an acute life-threatening condition, chronic condition likely to lead to complications, acute treatable condition, or other chronic treatable condition. It describes characteristics of ischemic cardiac pain and provides a differential diagnosis for chest pain that may be due to anxiety, cardiac, aortic, esophageal, lung/pleural, musculoskeletal, or neurological issues.
chestpain-150320061131-conversion-gate01 (1).pdf
Chest pain can be cardiac or non-cardiac in origin. Cardiac causes include angina, myocardial infarction, and pericarditis while non-cardiac causes include pulmonary embolism, pneumonia, gallbladder disease, and musculoskeletal disorders. Characteristics of ischemic cardiac chest pain include central location, radiation to the jaw/arm, tight or squeezing quality, and precipitation by exertion. Differential diagnosis of chest pain involves evaluating for life-threatening causes, chronic serious conditions, treatable acute conditions, and other chronic treatable conditions. Distinguishing ischemic cardiac chest pain from non-cardiac pain relies on characteristics such as location, quality, precipitating/relieving factors, and associated symptoms.
Chest pain
Chest pain can be cardiac or non-cardiac in origin. Cardiac causes include angina, myocardial infarction, and pericarditis while non-cardiac causes include pulmonary embolism, pneumonia, gallbladder disease, and musculoskeletal disorders. Characteristics of ischemic cardiac chest pain include a central, pressing or squeezing quality that radiates to the jaw/arm and is provoked by exertion. Differential diagnosis of chest pain requires evaluating characteristics like location, quality, duration and associated features to determine cardiac vs. non-cardiac etiology.
Thorax and Abdomin
The document discusses several conditions related to the thorax and abdomen, including:
1. Hypertrophic cardiomyopathy, a serious heart condition that causes an enlarged left ventricle, and can cause shortness of breath, fainting, and sudden death during physical activity.
2. Cardiac contusion and cardiac concussion, blunt force injuries to the chest that can cause arrhythmias, changes to heart sounds and EKGs, and sudden cardiac arrest.
3. Lung infections like bronchitis, as well as asthma, which is triggered by irritants and causes wheezing and difficulty breathing.
4. Pneumothorax, where air enters the pleural space causing lung
Cardiac assessment
This document provides information on various types of chest pain and their characteristics. It discusses:
- The location, duration, precipitating/relieving factors, and associated symptoms of angina, myocardial infarction, pericarditis, pulmonary embolism, gastrointestinal issues like peptic ulcer disease, and other potential causes.
- Descriptions of arrhythmias like premature ventricular contractions and their symptoms. Causes and presentations of cardiac arrest are also outlined.
- Details on performing a physical exam for signs of heart failure like edema, jugular vein distension, and orthopnea. Assessment of vital signs including orthostatic blood pressure changes is described.
Approach to chest pain
- Chest pain is a common reason for emergency department visits and hospitalizations, costing over $8 billion annually in the US. However, cardiac causes are only found in less than one third of patients.
- A thorough history and physical exam are important to determine the cause of chest pain and recognize life-threatening conditions like acute coronary syndrome. The character, location, radiation, timing and aggravating/relieving factors of the chest pain can provide clues to its origin.
- Electrocardiograms, blood tests, imaging studies and other diagnostic tests may be used to evaluate for conditions like heart attacks, pulmonary embolism, pneumonia and acid reflux as potential causes of chest pain. Recognizing these underlying
Chest Pain
This document discusses chest pain, its causes, symptoms, and characteristics. It begins with an introduction noting that chest pain can take many forms and sometimes radiates to other areas. The most serious causes involve the heart or lungs.
It then describes the locations, characteristics, and precipitating/relieving factors of chest pain from various potential sources. These include angina, myocardial infarction, costal cartilage issues, pulmonary embolism, pneumonia, and psychogenic causes.
Specific details are provided on diagnosing angina versus myocardial infarction based on pain location, duration, relieving/precipitating factors, and associated symptoms. A variety of cardiac, pulmonary, chest wall, and other potential non-cardiac causes
Approach to a patient with chest pain
This document discusses the evaluation and diagnosis of chest pain. It notes that chest pain is a common reason for medical attention and may be caused by cardiovascular, pulmonary, gastrointestinal, chest wall or psychological conditions. The history, physical exam, electrocardiogram and cardiac biomarkers can help diagnose causes like acute coronary syndrome, pericarditis, pulmonary embolism and pneumonia. Serial cardiac troponin testing can distinguish between unstable angina and non-ST-segment elevation myocardial infarction. The document provides details on symptoms and exam findings for various conditions that can cause chest pain.
Screening For Cardiovascular Disease
Chest pain or discomfort
Common presenting symptom of cardiovascular disease
May be cardiac or noncardiac in origin.
Cardiac – angina, MI, pericarditis, mitral valve prolapse, dissecting aortic aneurysm
Non cardiac – anemia (physical exertion), cervical disc disease, anxiety, trigger points etc
Follows pattern of ulnar nerve distribution (heart supplied by C3-T4 spinal segments)
Radiating pain to neck, jaw, upper trapezius, upper back, shoulder or arms (commonly left
Diseases of the pleura
This document provides an overview of diseases of the pleura, including pleurisy, pleural effusion, empyema, pneumothorax, and mesothelioma. It discusses the anatomy and physiology of the pleura, causes and characteristics of pleural diseases, and how they are investigated and managed. Key points include that pleurisy is inflammation of the pleura causing chest pain, pleural effusion is abnormal fluid accumulation in the pleural space, and the fluid can be transudative or exudative depending on the underlying cause such as heart failure or infection/malignancy respectively.
shortness_of_breath_and_chest_pain_lecture_emergency_medicine.pptx
This document discusses cardiac and respiratory conditions that can cause life-threatening chest pain. It lists common cardiac issues like heart attacks, angina, and aortic dissections. Respiratory conditions mentioned include pneumonia, pneumothorax, and pulmonary embolism. For each condition, it provides details on typical patient demographics, characteristics of their pain, diagnostic tests, and emergency treatments. The document is a medical reference for evaluating and managing patients presenting with acute chest pain.
Clinical assessment part 2
This document provides guidance on assessing symptoms related to cardiac issues in geriatric patients. It discusses how to evaluate dyspnea, cough, palpitations, chest pain, leg swelling, and other symptoms by asking about duration, onset, precipitating/relieving factors, and associated symptoms. Specific questions are provided to assess orthopnea, paroxysmal nocturnal dyspnea, hemoptysis, edema, and different types of chest pain. Causes and characteristics of different conditions like pulmonary venous congestion, acute pulmonary edema, and low cardiac output are also summarized.
Approach to Chest pain World Heart day 2022.pptx
- The document discusses the importance of recognizing life-threatening causes of chest pain like acute coronary syndrome (ACS) and treating it early to save lives.
- ACS includes conditions like unstable angina and myocardial infarction. According to the text, about 1/3 of patients presenting with chest pain have ACS, so it is important to properly evaluate and manage these patients.
- The document provides guidance on evaluating chest pain patients and distinguishing cardiac causes from other potential issues. It emphasizes the need for electrocardiograms, cardiac biomarkers like troponin levels, and imaging tests to make an accurate diagnosis and guide appropriate treatment.
Mubashar A Choudry MD | What is the mediastinal emphysema
Mediastinal Emphysema can be dangerous for people. According to Dr. Mubashar A Choudry Md, everyone should know about it.
respiratory system
This document provides information on various respiratory system conditions that can present with chest pain, cough, breathlessness, wheezing, or sore throat. It discusses evaluating and diagnosing these symptoms, including taking a thorough history and considering potential cardiovascular, gastrointestinal, or respiratory causes. Specific conditions mentioned include myocardial infarction, pneumonia, asthma, chronic bronchitis, emphysema, pulmonary embolism, pneumothorax, and various heart failures. Diagnostic factors like onset, duration, aggravating/relieving factors, associated symptoms, and physical exam findings are outlined for accurately assessing respiratory complaints.
I s c h a e m i a
This document discusses ischemia and risk factors for atherosclerosis. It defines ischemia as an imbalance between myocardial oxygen supply and demand. Major risk factors include high blood pressure, high cholesterol, smoking, obesity, and diabetes. The stages of atherosclerosis and strategies for prevention and treatment are discussed, including lifestyle changes, medications like ACE inhibitors, and diagnostic tests. Angina symptoms and types are summarized.
Unit 5_Complications of HTN(2).pptx
This document discusses complications of hypertension, including their mechanisms and management. It describes how high blood pressure can lead to left ventricular hypertrophy and atherosclerosis over time. Major complications discussed include heart failure, stroke, kidney failure, coronary artery disease/heart attack, and peripheral vascular disease. For each complication, key signs and symptoms are outlined as well as recommended actions like referral protocols. The document emphasizes preventing complications through proper treatment and control of hypertension and associated risk factors like diabetes and dyslipidemia.
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Acute ischaemic event
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- 2. Pathophysiology of Myocardial Ischaemia / Angina Angina/MI occurs when the Oxygen demand outweigh the oxygen supply. So, this imbalance might be contributed by increased requirement or reduced supply compared to normal conditions. Factors affecting the oxygen requirement include : Heart rate Contractility Wall tension (Systolic pressure and volume) Factors affecting the oxygen supply, thus coronary blood flow include : Muscle spasm Diastolic Time > Heart Rate Aortic Pressure- Left Ventricular End-Diastolic Pressure Gradient Local autoregulation * In relieving angina pectoris, nitrates exert favorable effects by reducing O2 requirements and increasing supply. Although a reflex increase in heart rate would tend to reduce the time for coronary flow, dilation of collaterals and enhancement of the pressure gradient for flow to occur as the left ventricular end-diastolic pressure (LVEDP) falls tend to increase coronary flow. Presentation of AMI Sudden death Resuscitated collapse Pain/ Discomfort : o S : Central chest , Below Maxilla, Above Umbilicus o O : Gradual onset
- 3. o C : Indigestion , Squeezing, chest discomfort o R : Left Arm, Left side of Neck o A : o T : Often last <12h (myocardium dead afterwards) o E : o S : Shortness of Breath (Dysponea) /Pulmonary Oedema Shock Arrhythmia Palpitation (Sense of impending doom) Nausea and Vomiting Dizziness/Lightheadedness/Weakness Sweating Anxiety Shock None/Incidental DDx of Acute Chest Pain System Syndrome Clinical Cardiac Stable Angina Retrosternal chest pressure, burning/heaviness, radiating to the neck/jaw/epigastrium/shoulder/left arm Unstable Angina Same as angina but more severe AMI Same as angina but more severe Pericarditis Sharp, pleuritic pain aggrevated by changes in position, duration variable Vascular Aortic dissection Excruciating, ripping pain of sudden onset of anterior chest pain radiating to the back Pulmonary embolism Sudden onset of SOB/dysponea and pain, pleuritic with pulmonary infarct Pulmonary hypertension Substernal chest pressure exarcebated by exertion Pulmonary Pleuritis +/- pneumonia Pleuritic pain, usually brief, localized area of lung involved Tracheobrochitis Burning discomfort of midline Spontaneous pneumothorax Spontaenous unilateral pleuritic pain + dysponea GIT GORD Burning substernal and epigastric discomfort, 10-60min duration Peptic ulcer Prolonged epigastric and substernal pain Gallbladder disease Prolonged epigastric / RUQ pain Pancreatitis Prolonged intense epigastric and substernal pain Musculoskeletal Costochondritis Cervical Disc Disease Infectious Herpes Zoster Prolonged burning pain in dermatome distribution Psychological Panic disorder Chest tightness/aching, accompanied by SOB, duration > 30min, unrelated to exertion/movement Treatment principles of acute myocardial infarction