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10 Cards in this Set
- Front
- Back
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Differential to chest pain |
Skin Chest wall Lungs Heart Aorta Oesohagus |
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Ischaemic pain properties |
Crushing retrosternal radiating - left arm, neck, JAW
Better at rest aggregated by exercise |
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Questions to ask to determine type of ischaemic chest pain |
Trope of pain Onset Previous heart attack Risk factor profile |
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Management of ischaemic chest pain |
ECG every 5-10 mins DAPT Sublingual nitrates o2 only if hypoxic Reperfusion (if stemi) Heparin (prevent thrombosis) B-blockers (slow HR) Statins (⬇️ cholesterol and inflamm) |
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Pleuritic pain properties |
Sharp stabbing pain Worse with coughing, breathing or change in position |
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Asymptomatic ischaemic pain candidates |
Diabetics Women Elderly |
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GORD properties |
Bitter taste in mouth Oesoph spasm, incompetence of lower oesp sphincter
ASSOC with MEALS Worse at night / lying down Not associated with exercise
Treat: ANTACIDS / proton pump inhibitors
Diagnose with gastroscopy or pH monitoring |
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Aortic dissection properties |
Shearing retrosternal pain Pain worse at ONSET Not dissection if symm of pulses and BP in arms Investigation: CT Echo TEE
Treat: BP control, URGENT SURGERY |
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Pericarditis properties |
Pleuritic chest pain Positional
ST elevation across all leads exc AVR Treat: NSAIDS |
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Golden rule for chest pain!! |
If unsure treat as angina!! |
