Haji General Hospital Surabaya

There is a disorder of the breast, marked with strong and peculiar

symptoms, considerable for the kind of danger belonging
to it, and not extremely rare, of which I do not recollectany mention among
medical authors. The seat of it, and sense of strangling and anxiety with
which it is attended, may make it not improperly be called angina
pectoris....

common complaint
Chest pain

life threatening

Differentiating Cardiac non Cardiac

Tabel 1. Cardiac and Noncardiac Causes of Chestpain

Cardiac Causes
Ischemic
Angina
Myocardial Infarction
Aortic Stenosis
Hyperthrophic cardiomyopathy
Coronary vasospasm
Non ischemic
Pericarditis
Aortic dissection
Mitral valve prolapse

Noncardial causes
Gastroesophageal
Reflux esophagitis
Esophageal Gastritis
Peptic ulcer
Pulmonary
Pneumothorax
Pulmonary embolism
Pleuritis
Neoplasm
Bronchitis
Musculoskeletal
Costochondritis
Rib fracture
Compression radiculopathy
Dermatologic
Herpes zoster
Karnath,et al. Review of clinical signs. Hospital physician.2004

ANGINA PECTORIS

The initial assessment requires a focused history (including

risk factor analysis), a physical examination, an
electrocardiogram, and frequently serum cardiac markers

ANAMNESA
character/Circumstance
Tabel 2

Gambar 1

Tabel 3.

Tabel 4.

Exacerbating/Alleviating Factors

Exercise, activity

Take a rest, drugs

Radiation

Canadian Cardiovascular Society Functional Classification of Angina

Timing
> Pattern: acute or chronic,contanstan or intermitten,
frequency,accelerating
> Onset: sudden, gradual
> Duration of episode of problem, change in duration
> Why is patient coming now

Relevant past medical history

Relevant social history

Alcohol, tobaco, or illiit drugs (cocaine)

Relevant family history
Impact patient perception of the problem , not add to
diagnosis

Physical Examination

Serum Cardiac Biomarkers