Chest Pain
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This document discusses chest pain, including its definition, location, potential causes, assessment process (using PQRST), and initial management. Chest pain can be caused by life-threatening conditions like a heart attack, pulmonary embolism, or aortic dissection. The assessment of a patient presenting with chest pain involves taking a medical history and examining the quality, location, radiation, timing and associated symptoms of the pain, as well as performing physical assessments like vital signs, electrocardiogram, chest x-ray and blood tests to check for potential cardiac issues. The initial management focuses on stabilizing the patient, administering oxygen, monitoring vitals, performing an electrocardiogram and blood tests, providing pain relief, and determining
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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.
Differential diagnosis of chest pain
This document discusses the differential diagnosis of chest pain by listing common cardiac, respiratory, gastrointestinal, and musculoskeletal causes. Key cardiac causes mentioned are angina, myocardial infarction, mitral valve prolapse, and pericarditis. Common respiratory causes listed are pleurisy, pneumothorax, and pulmonary embolism. Gastrointestinal causes such as reflux esophagitis and diffuse esophageal spasm are also summarized. The document provides brief descriptions of symptoms, signs, and investigations for each of these differential diagnoses of chest pain.
Understanding chest pain
This document discusses chest pain and various potential underlying conditions. It begins by explaining that chest pain can present in different areas of the upper torso and can radiate or refer to other locations. A wide range of cardiac, pulmonary, gastrointestinal, chest wall, and physiological conditions can cause chest pain. Two common cardiac conditions discussed in more detail are angina and heart attack. For angina, the document outlines signs, symptoms, and first aid treatment. For heart attack, it describes the pathophysiology, signs and symptoms, and emphasizes the need for rapid defibrillation or CPR and administration of aspirin if the individual loses consciousness.
Chest pain Case Presentation with management
CASE presentation of chest pain types, causes, investigations, management. cardiac vs non cardiac pain. life threatening chest pain. MI, ACS, PNEUMOTHORAX, PE, GERD, AORTIC DISSECTION.
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 approach
1. Chest pain is a common complaint that can be caused by cardiac, respiratory, gastrointestinal, vascular, musculoskeletal and other issues. A thorough history and physical exam is needed to determine the underlying cause.
2. A careful differential diagnosis should be established to identify life-threatening issues like acute coronary syndrome, pulmonary embolism, or aortic dissection versus more benign conditions.
3. Appropriate tests and investigations should then be ordered based on the leading clinical diagnosis to identify the cause of chest pain and guide management.
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.
Approach to Chest Pain
This document discusses the approach to evaluating chest pain, including differentiating typical vs atypical chest pain and providing a case example. It outlines evaluating a patient presenting with new chest pain by obtaining vital signs, EKG, and focused exam. Differentials for the case include PE, pneumonia, and MI. The Wells criteria and appropriate tests are reviewed, including D-dimer, CTPE, and V/Q scan to further evaluate for PE given the patient's moderate risk. Intravenous access is needed for CT angiogram to evaluate PE or aortic dissection.
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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.
Differential diagnosis of chest pain
This document discusses the differential diagnosis of chest pain by listing common cardiac, respiratory, gastrointestinal, and musculoskeletal causes. Key cardiac causes mentioned are angina, myocardial infarction, mitral valve prolapse, and pericarditis. Common respiratory causes listed are pleurisy, pneumothorax, and pulmonary embolism. Gastrointestinal causes such as reflux esophagitis and diffuse esophageal spasm are also summarized. The document provides brief descriptions of symptoms, signs, and investigations for each of these differential diagnoses of chest pain.
Understanding chest pain
This document discusses chest pain and various potential underlying conditions. It begins by explaining that chest pain can present in different areas of the upper torso and can radiate or refer to other locations. A wide range of cardiac, pulmonary, gastrointestinal, chest wall, and physiological conditions can cause chest pain. Two common cardiac conditions discussed in more detail are angina and heart attack. For angina, the document outlines signs, symptoms, and first aid treatment. For heart attack, it describes the pathophysiology, signs and symptoms, and emphasizes the need for rapid defibrillation or CPR and administration of aspirin if the individual loses consciousness.
Chest pain Case Presentation with management
CASE presentation of chest pain types, causes, investigations, management. cardiac vs non cardiac pain. life threatening chest pain. MI, ACS, PNEUMOTHORAX, PE, GERD, AORTIC DISSECTION.
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 approach
1. Chest pain is a common complaint that can be caused by cardiac, respiratory, gastrointestinal, vascular, musculoskeletal and other issues. A thorough history and physical exam is needed to determine the underlying cause.
2. A careful differential diagnosis should be established to identify life-threatening issues like acute coronary syndrome, pulmonary embolism, or aortic dissection versus more benign conditions.
3. Appropriate tests and investigations should then be ordered based on the leading clinical diagnosis to identify the cause of chest pain and guide management.
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.
Approach to Chest Pain
This document discusses the approach to evaluating chest pain, including differentiating typical vs atypical chest pain and providing a case example. It outlines evaluating a patient presenting with new chest pain by obtaining vital signs, EKG, and focused exam. Differentials for the case include PE, pneumonia, and MI. The Wells criteria and appropriate tests are reviewed, including D-dimer, CTPE, and V/Q scan to further evaluate for PE given the patient's moderate risk. Intravenous access is needed for CT angiogram to evaluate PE or aortic dissection.
Heart Attack and Its Management
This document discusses symptoms and management of various types of chest pain including angina pectoris, myocardial ischemia, gastroesophageal reflux, and costochondritis. Angina pectoris presents as tight chest pain brought on by exertion and relieved by rest. Myocardial ischemia causes longer lasting squeezing chest pain and can cause permanent heart damage. Management of potential heart attacks includes calling emergency services, administering oxygen and aspirin, and using nitroglycerin.
Chest pain emergencies
This document discusses the approach, differential diagnosis, initial tests, diagnostic tests, temporary treatment, and definitive management for three cases of chest pain. Case 1 involves a 48-year-old male with sudden severe chest pain. Case 2 is a 72-year-old female with chest discomfort and breathlessness. Case 3 is a 37-year-old female with central chest pain and history of breast cancer. Common differential diagnoses for chest pain include acute myocardial infarction, aortic dissection, pulmonary embolism, pneumonia, and perforated viscus. The document outlines the clinical clues, initial tests like ECG and CXR, additional diagnostic tests, and treatment strategies for each case and potential diagnosis.
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.
chest pain and homoeopathic management
The document provides an overview of homeopathic treatments for various cardiac and gastric conditions. It lists numerous homeopathic remedies for different types of heart diseases and issues, including conditions like endocarditis, pericarditis, palpitations, and more. It also lists remedies for various gastric derangements and issues like acid vomiting, ulcers, burning stomach pain, and more. The remedies are described in relation to their uses for specific symptom presentations.
Chest pain under evaluation
1) The document provides guidance for evaluating a patient presenting with chest pain, including conducting a primary survey, focused history, physical exam, and selecting initial diagnostic tests and investigations based on clinical suspicion.
2) Key considerations in differentiating potential deadly causes of chest pain like acute coronary syndrome, pulmonary embolism, aortic dissection, and pneumothorax include analyzing the description of pain, patient history, exam findings, and basic tests like ECG and CXR.
3) While chest pain descriptions and presentations can overlap between conditions, distinguishing features like radiation patterns, exacerbating/relieving factors, exam findings help prioritize the most concerning diagnoses for urgent treatment or further testing. Scoring systems and
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.
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.
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.
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.
Approach to chest pain
This document provides guidance on evaluating chest pain and discusses the approach to diagnosing aortic dissection. It emphasizes maintaining a high index of suspicion for aortic dissection as the symptoms can mimic other conditions. Aortic dissection often presents with sudden, severe chest or back pain and may migrate. Examination findings like pulse/blood pressure differences between limbs can help but have low sensitivity. The document reviews risk factors and recommends promptly ordering tests like CT scans to diagnose this dangerous condition given the high mortality if left untreated.
Chest Pain
This document provides information about chest pain, including its definition, common causes, symptoms, and guidelines for patient care. Chest pain can be caused by issues with the heart, lungs, esophagus, or other organs in the chest cavity. The physical examination and diagnostic tests are aimed at evaluating the chest, heart, and lungs to determine the underlying cause and appropriate treatment for the patient's chest pain.
Non cardiac chest pain
The document discusses the clinical approach to assessing patients presenting with non-cardiac chest pain. It outlines key objectives in rapidly and accurately evaluating these patients to form an accurate differential diagnosis and provide initial therapy. Chest pain is a common complaint, with cardiac and non-cardiac potential etiologies discussed. A focused history and physical exam can help differentiate causes like pulmonary embolism, pneumothorax, esophageal disorders, and musculoskeletal issues. Appropriate diagnosis and treatment depends on the suspected condition and patient stability.
Chest Pain- Differential Diagnosis
This document discusses the differential diagnosis of chest pain by describing various cardiac and non-cardiac causes. It outlines key factors in the history and physical exam that can help determine if chest pain is typical angina, atypical angina, or non-anginal. Common cardiac causes discussed include acute coronary syndromes, aortic dissection, and pericarditis. Common non-cardiac causes discussed include pulmonary embolism, pneumonia, gastrointestinal issues like pancreatitis and peptic ulcer disease. Diagnostic tests for different conditions are also mentioned.
Chest pain
This document discusses two cases of chest pain with different diagnoses:
1) A 62-year-old man presented with chest pain and was diagnosed with a myocardial infarction based on ECG findings.
2) A 23-year-old woman presented with chest pain and cough and was diagnosed with acute pericarditis based on ECG and exam findings showing a pericardial rub.
Chest pain cardiac or not Dr Yasser Diab
Chest pain cardiac or not with common pitfalls in diagnosis focusing into life threatening causes and quick glance at emergency management. auditorium at Farwaniya hospital ED ,State Of Kuwait.
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.
Evaluation of the adult chest pain in emergency department
Evaluation of the adult with chest pain in the emergency department is a big challenge and this presentation is very useful to know the major cause of chest pain and approach them
Approach to Chest Pain
1. A patient presented to the emergency room with chest pain. Initial assessment included ECG, cardiac monitoring, bloodwork, oxygen, aspirin, and morphine if not contraindicated.
2. Further evaluation depended on risk level based on history, exam, ECG findings, and cardiac enzymes. Low risk patients could be evaluated as outpatients, while higher risk patients required inpatient monitoring and treatment for acute coronary syndrome.
3. Ongoing management after discharge focused on lifestyle modifications like smoking cessation, exercise, diet, and medication adherence to control risk factors and prevent future events.
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.
Differential Diagnosis of chest pain. by Dr Joshua Walinjom
This document provides a differential diagnosis for chest pain by listing 10 potential causes: 1) acute coronary syndrome, 2) pneumonia, 3) GERD, 4) costochondritis, 5) anxiety, 6) pulmonary embolism, 7) pericarditis, 8) aortic dissection, 9) pneumothorax, and 10) peptic ulcer disease. For each cause, it describes the typical history, examination findings, investigations, and treatment considerations to aid clinicians in diagnosing the underlying reason for a patient's chest pain.
24 approach to chest pain
This document discusses the approach to evaluating and managing chest pain. It notes that chest pain accounts for millions of emergency department visits annually costing over $8 billion. The causes of chest pain are discussed, with musculoskeletal, gastrointestinal, and cardiac being most common. The initial approach to a patient with chest pain involves oxygen, IV access, monitoring, and an early ECG. A thorough history, physical exam including listening to heart and lungs, ECG, cardiac enzymes, CXR and other tests are used to evaluate the cause. Life-threatening conditions like myocardial infarction, pulmonary embolism, aortic dissection, and pericarditis require prompt diagnosis and treatment.
chest pain ddx final C3 (1).pptx
This document provides an overview of chest pain differentials (DDx). It begins by defining chest pain and discussing acute coronary syndrome. It then covers risk factors, symptoms, and physical exam findings for conditions like aortic dissection, acute pericarditis, cardiac tamponade, pulmonary embolism, tension pneumothorax, and esophageal rupture. Investigations, treatments, and management are described for each potential cause. The goal is to educate on evaluating and distinguishing between cardiac and non-cardiac causes of chest pain.
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Heart Attack and Its Management
This document discusses symptoms and management of various types of chest pain including angina pectoris, myocardial ischemia, gastroesophageal reflux, and costochondritis. Angina pectoris presents as tight chest pain brought on by exertion and relieved by rest. Myocardial ischemia causes longer lasting squeezing chest pain and can cause permanent heart damage. Management of potential heart attacks includes calling emergency services, administering oxygen and aspirin, and using nitroglycerin.
Chest pain emergencies
This document discusses the approach, differential diagnosis, initial tests, diagnostic tests, temporary treatment, and definitive management for three cases of chest pain. Case 1 involves a 48-year-old male with sudden severe chest pain. Case 2 is a 72-year-old female with chest discomfort and breathlessness. Case 3 is a 37-year-old female with central chest pain and history of breast cancer. Common differential diagnoses for chest pain include acute myocardial infarction, aortic dissection, pulmonary embolism, pneumonia, and perforated viscus. The document outlines the clinical clues, initial tests like ECG and CXR, additional diagnostic tests, and treatment strategies for each case and potential diagnosis.
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.
chest pain and homoeopathic management
The document provides an overview of homeopathic treatments for various cardiac and gastric conditions. It lists numerous homeopathic remedies for different types of heart diseases and issues, including conditions like endocarditis, pericarditis, palpitations, and more. It also lists remedies for various gastric derangements and issues like acid vomiting, ulcers, burning stomach pain, and more. The remedies are described in relation to their uses for specific symptom presentations.
Chest pain under evaluation
1) The document provides guidance for evaluating a patient presenting with chest pain, including conducting a primary survey, focused history, physical exam, and selecting initial diagnostic tests and investigations based on clinical suspicion.
2) Key considerations in differentiating potential deadly causes of chest pain like acute coronary syndrome, pulmonary embolism, aortic dissection, and pneumothorax include analyzing the description of pain, patient history, exam findings, and basic tests like ECG and CXR.
3) While chest pain descriptions and presentations can overlap between conditions, distinguishing features like radiation patterns, exacerbating/relieving factors, exam findings help prioritize the most concerning diagnoses for urgent treatment or further testing. Scoring systems and
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.
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.
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.
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.
Approach to chest pain
This document provides guidance on evaluating chest pain and discusses the approach to diagnosing aortic dissection. It emphasizes maintaining a high index of suspicion for aortic dissection as the symptoms can mimic other conditions. Aortic dissection often presents with sudden, severe chest or back pain and may migrate. Examination findings like pulse/blood pressure differences between limbs can help but have low sensitivity. The document reviews risk factors and recommends promptly ordering tests like CT scans to diagnose this dangerous condition given the high mortality if left untreated.
Chest Pain
This document provides information about chest pain, including its definition, common causes, symptoms, and guidelines for patient care. Chest pain can be caused by issues with the heart, lungs, esophagus, or other organs in the chest cavity. The physical examination and diagnostic tests are aimed at evaluating the chest, heart, and lungs to determine the underlying cause and appropriate treatment for the patient's chest pain.
Non cardiac chest pain
The document discusses the clinical approach to assessing patients presenting with non-cardiac chest pain. It outlines key objectives in rapidly and accurately evaluating these patients to form an accurate differential diagnosis and provide initial therapy. Chest pain is a common complaint, with cardiac and non-cardiac potential etiologies discussed. A focused history and physical exam can help differentiate causes like pulmonary embolism, pneumothorax, esophageal disorders, and musculoskeletal issues. Appropriate diagnosis and treatment depends on the suspected condition and patient stability.
Chest Pain- Differential Diagnosis
This document discusses the differential diagnosis of chest pain by describing various cardiac and non-cardiac causes. It outlines key factors in the history and physical exam that can help determine if chest pain is typical angina, atypical angina, or non-anginal. Common cardiac causes discussed include acute coronary syndromes, aortic dissection, and pericarditis. Common non-cardiac causes discussed include pulmonary embolism, pneumonia, gastrointestinal issues like pancreatitis and peptic ulcer disease. Diagnostic tests for different conditions are also mentioned.
Chest pain
This document discusses two cases of chest pain with different diagnoses:
1) A 62-year-old man presented with chest pain and was diagnosed with a myocardial infarction based on ECG findings.
2) A 23-year-old woman presented with chest pain and cough and was diagnosed with acute pericarditis based on ECG and exam findings showing a pericardial rub.
Chest pain cardiac or not Dr Yasser Diab
Chest pain cardiac or not with common pitfalls in diagnosis focusing into life threatening causes and quick glance at emergency management. auditorium at Farwaniya hospital ED ,State Of Kuwait.
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.
Evaluation of the adult chest pain in emergency department
Evaluation of the adult with chest pain in the emergency department is a big challenge and this presentation is very useful to know the major cause of chest pain and approach them
Approach to Chest Pain
1. A patient presented to the emergency room with chest pain. Initial assessment included ECG, cardiac monitoring, bloodwork, oxygen, aspirin, and morphine if not contraindicated.
2. Further evaluation depended on risk level based on history, exam, ECG findings, and cardiac enzymes. Low risk patients could be evaluated as outpatients, while higher risk patients required inpatient monitoring and treatment for acute coronary syndrome.
3. Ongoing management after discharge focused on lifestyle modifications like smoking cessation, exercise, diet, and medication adherence to control risk factors and prevent future events.
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.
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Evaluation of the adult chest pain in emergency department
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This document provides a differential diagnosis for chest pain by listing 10 potential causes: 1) acute coronary syndrome, 2) pneumonia, 3) GERD, 4) costochondritis, 5) anxiety, 6) pulmonary embolism, 7) pericarditis, 8) aortic dissection, 9) pneumothorax, and 10) peptic ulcer disease. For each cause, it describes the typical history, examination findings, investigations, and treatment considerations to aid clinicians in diagnosing the underlying reason for a patient's chest pain.
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This document discusses the approach to evaluating and managing chest pain. It notes that chest pain accounts for millions of emergency department visits annually costing over $8 billion. The causes of chest pain are discussed, with musculoskeletal, gastrointestinal, and cardiac being most common. The initial approach to a patient with chest pain involves oxygen, IV access, monitoring, and an early ECG. A thorough history, physical exam including listening to heart and lungs, ECG, cardiac enzymes, CXR and other tests are used to evaluate the cause. Life-threatening conditions like myocardial infarction, pulmonary embolism, aortic dissection, and pericarditis require prompt diagnosis and treatment.
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This document provides an overview of chest pain differentials (DDx). It begins by defining chest pain and discussing acute coronary syndrome. It then covers risk factors, symptoms, and physical exam findings for conditions like aortic dissection, acute pericarditis, cardiac tamponade, pulmonary embolism, tension pneumothorax, and esophageal rupture. Investigations, treatments, and management are described for each potential cause. The goal is to educate on evaluating and distinguishing between cardiac and non-cardiac causes of chest pain.
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Chest Pain in the Emergency Department.pptx
- Acute chest pain is a common reason for emergency department visits, accounting for around 10% of non-injury cases. It can be caused by cardiac, pulmonary, gastrointestinal, or other issues.
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This document provides information on evaluating and diagnosing chest pain. It discusses:
- The importance of history taking in determining the cause of chest pain.
- Common life-threatening causes of chest pain like myocardial infarction, aortic dissection, pulmonary embolism, and tension pneumothorax.
- How to assess chest pain through physical examination, ECG, cardiac enzymes, imaging studies, and other investigations.
- Distinguishing cardiac from non-cardiac chest pain and differentiating conditions like angina, unstable angina, and STEMI based on features.
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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.
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Pericardial effusion and cardiac tamponade are conditions caused by an abnormal accumulation of fluid in the pericardial space. Cardiac tamponade occurs when excess fluid buildup leads to reduced ventricular filling and hemodynamic compromise. Symptoms include breathlessness, chest pain, and hypotension. Diagnosis is made through ECG, echocardiogram, and x-ray. Treatment depends on severity but may include medications, drainage of fluid via pericardiocentesis, or surgery. Cardiac tamponade requires urgent pericardiocentesis to drain fluid and prevent further hemodynamic compromise.
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The document discusses myocardial infarction and acute coronary syndrome, providing definitions, causes, risk factors, types, pathophysiology, clinical manifestations, diagnostic measures, management, and nursing management of MI. It covers topics such as the epidemiology of MI/ACS, diagnostic criteria and biomarkers for diagnosis, treatments including percutaneous coronary intervention and fibrinolytic therapy, and complications of MI.
CVS and abdomen.pptx
This document provides guidance on performing a cardiac and abdominal examination. It outlines the objectives, symptoms, and physical examination techniques for assessing the cardiovascular and abdominal systems. The cardiovascular section covers inspection of the jugular veins, palpation of pulses, auscultation of heart sounds, and measurement of blood pressure. The abdominal section reviews inspection, auscultation, percussion and palpation techniques. Proper examination order and identification of normal versus abnormal findings are emphasized.
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Chest Pain
- 1. CHEST PAIN LARRY BIN GUTAH A & E DEPARTMENT 1ST CASE PRESENTATION
- 2. DEFINITION • Chest: • Pain: “ An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage ” (IASP 1986) • Chest pain: Localized sensation of discomfort or distress at chest .
- 3. Determine The PQRST Of The Pain P- Place of the pain. Q- Quality of the pain. (Pain Score) R- Radiation. S- Associated Symptoms. T- Timing.
- 4. LOCATION OF PAIN • Central pain Angina Oesophagitis Anxiety sharp pain may be came from pleural or pericardium. • Pain that not central Pleuritic Pain Fractured rib Ankylosing spondylitis Tabes dorsalis Gall blader and pancreatis disease
- 5. IX • PHYSICAL VS ECG CXR ULTRA SOUND • Laboratory FBC BUSE/RBS CARDIAC ENZYME (CK-MB/TropT/Trop I etc)
- 6. PT CAME WITH c/o OF CHEST PAIN CAN BE SUSPECT AS??? • LIFE THREATENING Acute myocardial infarction Angina / acute coronary syndrome Aortic dissection Tension pneumothorax Pulmonary embolism Esophageal rupture.
- 8. CXR AORTA DISSECTION
- 12. • OTHERS Pneumonia Empyema Chest Wall pain Muscular Ribs Fractures Bony mestastases Costocondritis Pleurisy Pericarditis Intra abdominal Cholecystitis Peptic ulceration Pancreatitis
- 13. MX • Put pt prop-up, • O2 supplement, • Vital sign monitoring. • Immediate 12 lead ECG &monitoring, • Set up IV and take blood. • Give pain relief depending on provisional diagnosis. • Admit pt • Stable angina can be discharged with medications.
- 14. REFERENCE • Oxford Fajar Dictionary 3rd Edition • Oxford Handbook Of Clinical Medicine 4th & 6 Edition • Talley Nj, O’connor S. Pocket Clinical Examination. Sydney; 1996.
- 15. THANK YOU