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CHEST PAIN

CARDIAC

CARDIAC

NON(continued..)

Coronary
Artery Disease

Non-Coronary
Artery Disease
-sudden searing chest pain
- radiation to back, abdomen,

or
-

neck
Anterior pleuritic chest pain
- hypertension
- sharp pain
- BP difference between left

-precordial chest pain


and
-lasts <3 minutes
- localized
right extremities
-radiates to left shoulder
- worse supine than upright -acute aortic
regurgitation
or upper arm
- pericardial rub
-precipitated by stress
- following URTI
or exertion
- ST elevation in all leads
-relieved rapidly by
rest or nitrates
-precordial chest pain
Aortic dissection
-history of angina
- lasts > 30 mins
- no ST elevation
- radiates to left shoulder
or upper arm
- occurs at rest
pericarditis
- not relieved with nitrates
- abnormal CKMB, Troponin T

ST elevation
Chronic stable
angina pectoris
dysfunction
STEMI

-pleuritic or pericardial
non ST elevation
chest pain
- following URTI
- cardiomegaly and
contractile

non STEMI
myocarditis

-more severe precordial chest pain


- lasts <30 mins
- radiates to left shoulder
or upper arm
- occurs at rest
- recent onset
- not relieved with nitrates
- normal CKMB, Troponin T
- no ST elevation

Unstable angina pectoris

NON CARDIAC

-sharp pain
-pain on front of chest wall
pain
exertion
- affects more than
heart
one rib
-pain on palpation
ventricular
- worsens on taking
deep breath or coughing
pulmonary

-sharp chest pain


with breathing

- dyspnea

- heart burn
- epigastric pain

-dyspnea
-fatigue
- chest

- food- relief pattern

- syncope on

- pain relieved by antacid

-splitting of second

- hemoptysis
- syncope

sound
- right atrial or

- tachypnea
- ventilation perfusion defect

hypertrophy on ecg
- enlarged central

- localized and severe chest pain

GERD

artery on radiograph

Pulmonary embolism
Costochondritis
- no abnormalities on
physical examination - spontaneous fright
- anxiety
- palpitations
- dyspnea
- faintness
- all in the last six months

Anxiety disorder

Pulmonary hypertension