8. Chest pain Differential Dx Flashcards Preview

ESA 2- Cardiovascular System > 8. Chest pain Differential Dx > Flashcards

Flashcards in 8. Chest pain Differential Dx Deck (18):
1

Suggest 6 common causes for chest pain.

Cardiac causes:
1. Ischaemic (lack of myocyte blood supply)
2. Pericarditis (pericardial sac inflammation)

Respiratory causes:
3. Pulmonary embolism
4. Pneumonia

Upper GI causes:
5. e.g. acid reflux, indigestion

Musculoskeletal causes:
6. e.g. rib fracture, costalcondritis (costal cartilage inflammation)

2

What are the common causes of pericarditis?

1. usually infection, esp. viral
2. chest injury
3. some cancers and some treatments (e.g. radiotherapy, chemotherapy)
4. immune system problems (in chronic/recurring pericarditis)

More common in men and adults.

3

Where would chest pain caused by ischaemia be located? What quality pain would this be?

- central/retrosternal
- poorly localised
- may radiate to jaw, neck, shoulder, (left arm)

- dull pain (pressure, heaviness)

4

Where would chest pain caused by pericarditis be located? What quality pain would this be?

- central/retrosternal
- localised to anterior chest
- may have referred pain in shoulder

- sharp pain

5

Where would chest pain caused by pneumonia be located? What quality pain would this be?

- vague, often lateral

- dull pain

6

Where would chest pain caused by pulmonary embolism be located? What quality pain would this be?

- well localised

- absent or sharp pain

7

Where would chest pain caused by upper GI problems be located?

- central or running up into chest

- burning pain

8

Where would chest pain caused by musculoskeletal problems be located?

- well localised

- sharp pain

9

Why might someone with pericarditis have referred pain in shoulder?

Due to diaphragm irritation - diaphragm innervated by phrenic nerve which shares C3, 4 and 5 with shoulder dermatomes.

10

What are the differences between visceral and somatic chest pain?

1. Visceral pain (heart and lungs)
- dull, poorly localised
- worsened with exertion

2. Somatic pain (pericardial and pleural sac)
- sharp, often well localised
- worsened by inspiration, coughing or positional mov.

11

Which factors aggravate or relieve ischaemic chest pain?

Aggravates: exertion

Relieves: rest (sometimes)

12

Which factors aggravate or relieve pericarditis chest pain?

Aggravates:
- chest wall mov. - inspiration/coughing
- lying flat

Relieves: sitting up and leaning forward

13

Which factors aggravate or relieve pulmonary embolism chest pain?

Chest wall movement: inspiration/coughing

14

Which factors aggravate or relieve upper GI-caused chest pain?

1. lying flat
2. food intake

15

Which factors aggravate or relieve MSK-caused chest pain?

Chest wall movement: inspiration/coughing

16

Which clinical signs during auscultation and ECG are specific to pericarditis?

1. Auscultation: pericardial rub (harsh/coarse beat)
2. ECG: widespread ST elevation with saddle-shape appearance

17

Which clinical signs are specific to pneumonia?

1. temperature
2. cough
3. breathlessness

18

Which clinical signs are specific to MSK-caused chest pain?

tender to palpate