Cardiogenic shock differential diagnosis: Difference between revisions

Latest revision as of 13:14, 16 April 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2] Syed Musadiq Ali M.B.B.S.[3] Ramyar Ghandriz MD [4]

Overview

Shock is a clinical syndrome resulting from the hypoperfusion of the tissues. Regardless of the underlying cause, this hypoperfusion leads to the failure to meet tissues' nutritional and oxygen needs, causing cellular dysfunction. The affected tissues lead to the production and release of inflammatory mediators that will further jeopardize perfusion through changes in the vasculature. The results of these changes are organ failure and death if treatment in not timely applied. According to the underlying cause, there will be different types of shock, which will have similar presentations. It is mandatory to determine the underlying cause of the condition so that proper treatment may be started. Cardiogenic shock is a clinical condition, defined as a state of systemic hypoperfusion originated in cardiac failure, in the presence of adequate intravascular volume, typically followed by hypotension, which leads to insufficient ability to meet oxygen and nutrient demands of organs and other peripheral tissues. It may range from mild to severe hypoperfusion and may be defined in terms of hemodynamic parameters, which according to most studies, means a state in which systolic blood pressure is persistently < 90 mm Hg or < 80 mm Hg, for longer than 1 hour, with adequate or elevated left and right ventricular filling pressures that does not respond to isolated fluid administration, is secondary to cardiac failure and occurs with signs of hypoperfusion (oliguria, cool extremities, cyanosis and altered mental status) or a cardiac index of < 2.2 L/min/m² (on inotropic, vasopressor or circulatory device support) or < 1.8-2.2 L/min/m² (off support) and pulmonary artery wedge pressure > 18 mm Hg.

Differential Diagnosis

Depending on the author and the source used there will be different ways of organizing the types of shock. Sometimes it might be difficult to differentiate, from the clinical standpoint, two types of shock since components of each type may combine in a single patient. The clinical presentation of shock is usually the result of a complexity of processes, such as the sympathetic and endocrine responses to hypoperfusion, along with manifestations of organ failure. Patients who present with signs and symptoms of hypoperfusion following a diagnosed or suspected myocardial infarction, are commonly suffering a cardiogenic shock as a complication of the MI. However, other clinical scenarios, not related to acute MI, may present similarly:^[1]^[2]

Hypovolemic shock

More than a simple loss of intravascular volume, hypovolemic shock is a dynamic process in which the responses to the initial insult, and the period of time during which they are in practice, will dictate the response to treatment and therefore the outcome. Several causes may be in the origin of this type of shock, including: hemorrhage, dehydration, GI or urinary losses and severe venodilation (in the setting of other conditions). There is a relationship between the clinical status of the patient and the amount of circulating blood volume, the signs may include pallor, cool extremities, tachycardia and tachypnea, oliguria and decreased consciousness. Compensatory mechanisms are responsible for tolerating initial blood loss, however they begin to fail after about 20-25% of blood has been lost. This tolerance will be dictated mostly by the previous cardiac reserve of the patient, along with the velocity of loss of intravascular volume^[3]^[4].
When comparing hypovolemic and cardiogenic shock (most commonly complicating acute-MI) some specific clinical signs of shock will be similar, however, others will be different, particularly signs of CHF, such as the presence of distended jugular and peripheral veins, presence of an S3 sound and pulmonary edema on the cardiogenic type.
When comparing hemodynamic data, similarities include: decreased cardiac index, stroke volume index, cardiac output, mixed venous oxygen saturation and increased difference in arteriovenous O₂ saturation and SVR.

Differences to be noted include:

<math>\mbox{Shock index} = \frac{heart\ rate}{systolic\ blood\ pressure}</math>

Other measures include: decreased ventricular preload, ventricular diastolic volumes and pressures, pulmonary wedge pressure and central venous pressure.

When treating hypovolemic shock it's mandatory to rule out cardiogenic cause because part of the treatment for hypovolemic shock, urgent intravascular volume replacement, may further jeopardize the cardiac condition in the cardiogenic form.

Obstructive shock

This form of shock results from an obstruction to the flow of blood through the cardiovascular system, including the vessels and the heart. Therefore, different causes may give rise to this condition, such as: tension pneumothorax, pulmonary emboli, pericardial tamponade and constrictive pericarditis.^[5] As in other types of shock, the clinical response will be heavily dictated by the timespan during which the insult develops and urgent therapy must be applied^[6]^[7].
To evaluate the hemodynamics of obstructive shock it is important to know the underlying etiology of the shock, since different causes will present with different hemodynamic values. One example of cause of obstructive shock is cardiac tamponade, which, similarly to the cardiogenic form, will likely present with: decreased cardiac index, stroke volume, stroke work, mixed venous oxygen saturation and increased difference in arteriovenous O₂ saturation, right and left ventricular diastolic pressures, pulmonary artery diastolic pressure, serum lactate and CVP. Other causes may be observed on the table below.

Distributive shock

The hallmark of this form of shock is the decrease of peripheral resistance. This may be present in a series of conditions that may lead to distributive shock, such as: sepsis, anaphylaxis, toxic shock syndrome and adrenal crisis.
When compared to cardiogenic shock it presents with similarities, such as: decreased cardiac index, left and right ventricular stroke work and increased serum lactate. The differences reside in: overall decreased of SVR, which after fluid resuscitation may become elevated, ventricular filling pressure, difference in arteriovenous O₂ saturation and increase of mixed venous oxygen saturation. It is important to note that, unlike cardiogenic and other types of shock, in the distributive kind there is an increase in venous oxygen saturation which, despite the increased O₂ demand, might be due to the increased total body perfusion, that is responsible for diminishing the effectiveness of individual tissue perfusion^[8]^[9]^[10].

*Classification of shock based on hemodynamic parameters.* (CO, cardiac output; CVP; central venous pressure; PAD, pulmonary artery diastolic pressure; PAS, pulmonary artery systolic pressure; RVD, right ventricular diastolic pressure; RVS, right ventricular systolic pressure; SVO2, systemic venous oxygen saturation; SVR, systemic vascular resistance.)^[11]^[12]
Type of Shock	Etiology	CO	SVR	PCWP	CVP	SVO2	RVS	RVD	PAS	PAD
Cardiogenic	Acute Ventricular Septal Defect	↓↓	↑	N — ↑	↑↑	↑ — ↑↑	N — ↑	↑	N — ↑	N — ↑
	Acute Mitral Regurgitation	↓↓	↑	↑↑	↑ — ↑↑	↓	↑	N — ↑	↑	↑
	Myocardial Dysfunction	↓↓	↑	↑↑	↑↑	↓	N — ↑	N — ↑	N — ↑	↑
	Right Ventricular Infarction	↓↓	↑	N — ↓	↑↑	↓	↓ — ↑	↑	↓ — ↑	↓ — ↑
Obstructive	Pulmonary Embolism	↓↓	↑	N — ↓	↑↑	↓	↓ — ↑	↑	↓ — ↑	↓ — ↑
Obstructive	Cardiac Tamponade	↓ — ↓↓	↑	↑↑	↑↑	↓	N — ↑	↑	N — ↑	N — ↑
Distributive	Septic Shock	N — ↑↑	↓ — ↓↓	N — ↓	N — ↓	↑ — ↑↑	N — ↓	N — ↓	↓	↓
Distributive	Anaphylactic Shock	N — ↑↑	↓ — ↓↓	N — ↓	N — ↓	↑ — ↑↑	N — ↓	N — ↓	↓	↓
Hypovolemic	Volume Depletion	↓↓	↑	↓↓	↓↓	↓	N — ↓	N — ↓	↓	↓

The following table outlines the major differential diagnoses of Shock on the basis of clinical manifestations..^[13]^[14]^[15]^[16]^[17]^[18]^[19]^[20]^[21]^[22]^[23]^[24]^[25]^[26]^[27]^[28]^[29]^[30]^[31]^[32]^[33]^[34]^[35]^[36]^[37]^[38]^[39]^[40]^[41]^[42]^[43]^[44]^[45]^[46]^[47]^[48]

Abbreviations: ABG (arterial blood gas); ACE (angiotensin converting enzyme); BMI (body mass index); CBC (complete blood count); CSF (cerebrospinal fluid); CXR (chest X-ray); ECG (electrocardiogram); FEF (forced expiratory flow rate); FEV1 (forced expiratory volume); FVC (forced vital capacity); JVD (jugular vein distention); MCV (mean corpuscular volume); Plt (platelet); RV (residual volume); SIADH (syndrome of inappropriate antidiuretic hormone); TSH (thyroid stimulating hormone); Vt (tidal volume); WBC (white blood cell); Coronary CT angiography (CCTA); multidetector row scanners (MDCT); Cardiovascular magnetic resonance — CMRI; Myocardial perfusion imaging (MPI); single-photon emission CT (SPECT); Positron emission tomography (PET) scanning; Magnetic resonance (MR) angiography, Computed tomographic (CT) angiography, and Transesophageal echocardiography (TEE), late gadolinium enhancement (LGE); right ventricular hypertrophy (RVH), right atrial enlargement (RAE), functional tricuspid regurgitation (TR), Pulmonary artery systolic pressure (PASP; adenosine deaminase (ADA); Serum amyloid A (SAA), soluble interleukin-2 receptor (sIL2R); High-resolution CT (HRCT) scanning

Differentials on the basis of Etiology	Disease	Clinical manifestations										Diagnosis
		Symptoms								Risk factors	Physical exam	Lab Findings	EKG	Imaging	Gold standard
		Onset	Duration	Quality of Pain	Cough	Fever	Dyspnea	Weight loss	Associated Features	Risk factors	Physical exam	Lab Findings	EKG	Imaging	Gold standard
	Myocardial Infarction^[13]^[14]^[15]^[16]	Acute	Commonly > 20 minutes	Same as stable angina but often more severe	-	-	+	-	Nausea and vomiting Diaphoresis Presyncope Palpitations Lateral displacement of the apical impulse	Dyslipidemia, hypertension, smoking, family history of premature disease, and diabetes	Hypotension Tachycardia S4 gallop Paradoxical splitting of S2 Mitral regurgitation murmur	Elevated cardiac enzymes ↑B-Type Natriuretic Peptide	ST elevation MI (STEMI) Non-ST elevation MI (NSTEMI) or Non Q wave	Echocardiography: ↓ EF CCTA: Coronory artery stenosis CMRI: Coronory vessels stenosis MPI on SPECT or PET scanning: Decreased myocardial perfusion.	CCTA combined with MPI
Cardiac
	Aortic Dissection^[49]^[50]	Sudden severe progressive pain (common) or chronic (rare)	Variable	Tearing, ripping sensation, knife like	-	-	+	-	Focal neurologic deficit Hypotension	Hypertension Genetically mediated collagen disorders Preexisting aortic aneurysm Bicuspid aortic valve Aortic coarctation Turner syndrome Vasculitis (giant cell arteritis, Takayasu arteritis, rheumatoid arthritis, syphilitic aortitis)	Pulse deficit New diastolic murmur Diastolic decrescendo murmur Focal neurologic deficit Hypotension	D-dimer <500 ng/mL rules out aortic dissection ↑Soluble ST2 (sST2) Measurements of soluble elastin fragments, smooth muscle myosin heavy chain, high-sensitivity C-reactive protein, fibrinogen, and fibrillin fragments	Nonspecific ST and T wave changes	CXR: Mediastinal and/or aortic widening CTA: A compressed true lumen MRA: Detects differential flow between the true and false lumens, widening of the aorta with a thickened wall TEE: Intimal dissection flaps, true and false lumens, thrombosis in the false lumen Aortography: Distortion of the normal contrast column, Flow reversal or stasis into a false channel, Failure of major branches to fill, and Aortic valvular regurgitation	CT angiography Digital subtraction aortography (if high suspicion)
	Aortic intramural hematoma	Sudden severe progressive pain (common) or chronic (rare)	Variable	Tearing, ripping sensation, knife like	-	-	+	-	Focal neurologic deficit Hypotension	Hypertension Genetically mediated collagen disorders Preexisting aortic aneurysm Bicuspid aortic valve Aortic coarctation Turner syndrome Vasculitis (giant cell arteritis, Takayasu arteritis, rheumatoid arthritis, syphilitic aortitis)	Pulse deficit New diastolic murmur Diastolic decrescendo murmur Focal neurologic deficit Hypotension	D-dimer <500 ng/mL rules out aortic dissection ↑Soluble ST2 (sST2) Measurements of soluble elastin fragments, smooth muscle myosin heavy chain, high-sensitivity C-reactive protein, fibrinogen, and fibrillin fragments	Nonspecific ST and T wave changes	CXR: Mediastinal and/or aortic widening CTA: A compressed true lumen MRA: Detects differential flow between the true and false lumens, widening of the aorta with a thickened wall TEE: Intimal dissection flaps, true and false lumens, thrombosis in the false lumen Aortography: Distortion of the normal contrast column, Flow reversal or stasis into a false channel, Failure of major branches to fill, and Aortic valvular regurgitation	CT angiography Digital subtraction aortography (if high suspicion)
	Penetrating atherosclerotic aortic ulcer^[51]^[52]^[53]	Sudden severe pain	Variable	Tearing, ripping sensation, knife like	-	-	+	-	Hypotension Back pain Hypovolemic shock	Hypertension Smoking Hyperlipidemia Atherosclerosis Male gender Older age Bicuspid aortic valve Prior aortic surgery Prior aortic dilatation	Hypotension	_	_	CXR: Mediastinal and/or aortic widening, diffuse or focal enlargement of thoracic descending aorta, pleural effusion, and deviated trachea CTA: Presence of false aneurysm	CT angiography Contrast-enhanced CT scan
	Pericardial Tamponade^[54]^[55]	Acute or subacute	May last for hours to days	Sharp and stabbing retrosternal pain	+/-	+	+	-	Pulsus paradoxus Pericardial rub	HIV TB Immunosuppression Acute trauma	Kussmaul sign Beck triad Pulsus paradoxus	Creatine kinase and isoenzymes Abnormal LFTs Antinuclear antibody assay, erythrocyte sedimentation rate and rheumatoid factor HIV testing	EKG findings: Sinus tachycardia Low QRS voltage Electrical alternans	CXR: enlarged cardiac silhouette with clear lung fields Echocardiography: Chamber collapse, Respiratory variation in volumes and flows, IVC plethora Swan-Ganz Catheterization: Equilibration of average intracardiac diastolic pressures (usually between 10 and 30 mmHg)	Echocardiography
	Myocarditis^[56]^[57]^[58]	Acute or subacute	Variable	Sharp & localized retrosternal pain reflects associated pericarditis	+/-	+	+	-	Heart failure Sudden cardiac death Arrythmias	Ischemic heart disease Valvular heart disease	S3 and S4 gallop Cardiac murmurs Pericardial friction rub	Serum cardiac troponin levels ↑ BNP or NT-proBNP level	Nonspecific ST changes, single atrial or ventricular ectopic beats, complex ventricular arrhythmias	CXR: Normal to enlarged with or without pulmonary vascular congestion and pleural effusions Echo: Left ventricular dilation, changes in left ventricular geometry (eg, development of a more spheroid shape), and wall motion abnormalities CMR: T1 and T2 signal intensity consistent with edema, presence of LGE consistent with necrosis or scar Radionuclide ventriculography: ↓ EF Cardiac catheterization: Assessment of hemodynamic status	Endomyocardial biopsy
	Hypertrophic cardiomyopathy^[59]^[60]^[61]	Acute or subacute	Variable	Typical or atypical chest pain	-	-	+	-	HF Arrhythmias Syncope Acute hemodynamic collapse	Positive family history of sudden cardiac death Genetic mutation	S4 Systolic murmurs LV apical impulse Brisk carotid pulse ↑ JVP A parasternal lift	Non-specific	Prominent abnormal Q waves P wave abnormalities Left axis deviation Deeply inverted T waves	Echocardiography: LV hypertrophy Systolic anterior motion of the mitral valve, LVOT obstruction Cardiac catheterization Pressure gradient Augmentation of the gradient Aortic pressure Left ventricular pressure Left atrial or pulmonary capillary wedge pressure Coronary angiography Obstructive epicardial coronary artery disease Genetic testing for HCM: Sarcomere mutation in an athlete with a maximal LV wall thickness in the "grey zone"	Genetic testing for HCM
	Stress (takotsubo) Cardiomyopathy^[62]^[63]^[64]^[65]	Acute	Commonly > 20 minutes	Substernal heaviness or tightness	-	-	+	-	Setting of physical or emotional stress or critical illness	Stress	Murmurs and rales may be present on auscultation in the setting of acute pulmonary edema	Catecholamines transiently elevated ↑TnT level ↑BNP level	ST segment elevation ST depression QT interval prolongation, T wave inversion, abnormal Q waves	Radionuclide myocardial perfusion imaging: Transient perfusion abnormalities in the left ventricular apex	Ventriculography and invasive coronary angiography
	Aortic Stenosis^[66]^[67]^[68]	Acute, recurrent episodes of angina	2-10 minutes	Heaviness/pressure/ tightness/squeezing/ burning (Levine's sign) Retrosternal	-	-	+	-	Dyspnea and decreased exercise tolerance Dizziness and syncope Angina pectoris	HTN Old age	S2 is soft, single and paradoxically split A2 delayed and tends to occur simultaneously with P2 Aortic ejection click Fourth heart sound (S4) can also be heard Crescendo–decrescendo murmur	Schistiocytes on peripheral blood smear	Non specific (the voltage of the QRS complex is increased showing the presence of left ventricular hypertrophy)	Echocardiography: aortic leaflets thickened and calcified, ↑ pulmonary artery pressure) CMR: Myocardial fibrosis, evaluation of aortic anatomy and size MDCT: Degree of aortic valve calcification PET: Measures active mineralization which correlates with stenosis severity	Echocardiography
	Heart Failure^[69]^[70]^[71]	Subacute or chronic	Variable	Dull Left sided chest pain	+	+/-	+	+	Orthopnea Peripheral edema Hemoptysis	Dyslipidemia, hypertension, smoking, family history of premature disease, and diabetes	S3 Elevated JVP Peripheral edema	Hyponatremia Hypoalbuminemia ↑ Serum brain natriuretic peptide (BNP) or NT-proBNP level A mild elevation in serum bilirubin (total bilirubin <3 mg/dL)	EKG findings are specific according to each cause of heart failure Q waves, ST and T wave abnormalities in patients with prior MI New onset arrhythmias (atrial fibrillation and ventricular tachycardia)	CXR: Cardiomegaly Echocardiography: ↓ EF Right heart catheterization: Pulmonary capillary wedge pressure >20 mmHg, right atrial pressure ≥12 mmHg) and/or decreased cardiac index (≤2.2 L/min/m2	Echocardiography
Differentials on the basis of Etiology	Disease	Clinical manifestations										Diagnosis
		Symptoms								Risk factors	Physical exam	Lab Findings	EKG	Imaging	Gold standard
		Onset	Duration	Quality of Pain	Cough	Fever	Dyspnea	Weight loss	Associated Features	Risk factors	Physical exam	Lab Findings	EKG	Imaging	Gold standard
Pulmonary	Pulmonary Embolism^[72]^[73]	Acute	May last minutes to hours	Sharp or knifelike or pleuritic pain Localized to side of lesion	+	+/-	+	-	Hemoptysis History of venous thromboembolism or coagulation abnormalities.	Hormone replacement therapy Cancer Oral contraceptive pills Stroke Pregnancy Postpartum Prior history of VTE Thrombophilia	S3 or S4 gallop Low grade fever Tachycardia Tachypnea Hypoxia	↑D-dimer ≥500 ng/mL Arterial blood gases (Respiratory alkalosis) ↑Troponin levels Hypercoagulation workup	Tachycardia and nonspecific ST-segment and T-wave changes (70 percent) S1Q3T3 pattern New right bundle branch block Inferior Q-waves (leads II, III, and aVF)	Duplex Ultrasonography: DVT CXR: Westermark sign, Hampton hump, Palla's sign Echocardiography: RV dilation (ratio of apical 4-chamber RV diameter to left ventricle (LV) diameter > 0.9) RV systolic dysfunction Ventilation-Perfusion Scanning: High probability	CT pulmonary angiography
	Spontaneous Pneumothorax^[74]^[75]	Acute	May last minutes to hours	Sharp Localized pleuritic	-	-	+	-	Respiratory distress Tachypnea Asymmetric lung expansion Hyperresonance on percussion Decreased tactile fremitus Tachycardia Cardiac apical displacement	Smoking Positive family history Marfan syndrome Homocystinuria Thoracic endometriosis.	Decreased breath sounds on involved side Lung sounds transmitted from the unaffected hemithorax are minimal with auscultation at the midaxillary line Adventitious lung sounds (crackles, wheeze; an ipsilateral finding) Pulsus paradoxus	Respiratory alkalosis on ABGs	Rightward shift in the mean electrical axis Loss of precordial R waves Diminution of the QRS voltage Precordial T wave inversions	CXR: White visceral pleural line on the chest radiograph CT: small amounts of intrapleural gas, atypical collections of pleural gas, and loculated pneumothoraces	CT scan
	Tension Pneumothorax^[76]^[77]	Acute	May last minutes to hours	Sharp Pleuritic	-	-	+	-	Hypotension Jugular venous distention Respiratory distress	Trauma	Decreased breath sounds on involved side Lung sounds transmitted from the unaffected hemithorax are minimal with auscultation at the midaxillary line Adventitious lung sounds (crackles, wheeze; an ipsilateral finding) Pulsus paradoxus	Respiratory alkalosis on ABGs	Significant elevation of the ST-T segment from leads V1 to V4	CXR: A distinct shift of the mediastinum to the contralateral side, collapse of the ipsilateral lung, and flattening or inversion of the ipsilateral hemidiaphragm	CT scan
	Pleural Effusion^[78]^[79]^[80]	Acute or subacute or chronic	Variable	Dull Pleuritic pain	+	+/-	+	+/-	Increasing lower extremity edema Orthopnea Paroxysmal nocturnal dyspnea Night sweats Hemoptysis	Pneumonia	Diminished or inaudible breath sounds Pleural friction rub Egophony (known as "E-to-A" changes)	Pleural fluid LDH levels above 1000 IU/L Nucleated cells - Lymphocytosis - Eosinophilia - Mesothelial cells Pleural fluid culture and cytology Pleural fluid antinuclear antibody and rheumatoid factor	Typically not indicated	Chest X Ray: Pleural fluid on one or both sides Computerized tomography (CT) scan: Detects small pleural effusions, ie, less than 10 mL and possibly as little as 2 mL of liquid in the pleural space, Thickening of the visceral and parietal pleura MRI: Characterize the content of pleural effusions	Computed tomography
	Acute chest syndrome (Sickle cell anemia)^[81]^[82]^[83]	Acute	May last minutes to hours	Chest tightness	+	+/-	+	-	Sickle cell anemia Vaso-occlusive crisis Pain crises	↑ WBC ↑ Hb levels ↓ fetal hemoglobin levels Smoking Vaso-occlusive pain events	Systolic murmur may be heard over the entire precordium	↑Erythrocyte sedimentation rate Peripheral blood smears: Schistiocytes ↑ Reticulocyte count	EKG typically not indicated	Plain radiography of the extremities: Avascular necrosis	---
Differentials on the basis of Etiology	Disease	Clinical manifestations										Diagnosis
		Symptoms								Risk factors	Physical exam	Lab Findings	EKG	Imaging	Gold standard
		Onset	Duration	Quality of Pain	Cough	Fever	Dyspnea	Weight loss	Associated Features	Risk factors	Physical exam	Lab Findings	EKG	Imaging	Gold standard
Gastrointestinal	Perforated Peptic Ulcer^[84]^[85]^[86]	Acute	Minutes to hours (gastroesophageal reflux) Prolonged (peptic ulcer) 5 to 60 minutes	Burning Substernal Epigastric	+/-	-	-	+/-	Visceral, substernal, worse with recumbency, no radiation, relief with food, antacids Hematemesis or melena resulting from gastrointestinal bleeding Dyspepsia	Prolonged NSAIDs intake Smoking Alcohol abuse Spicy foods H-pylori infection	Not any auscultatory findings associated with this disease Enamel erosion or other dental manifestations	↑Serum Gastrin Level Secretin Stimulation Test H-Pylori testing	EKG usually normal but may show T wave inversions in leads V2 through V4 consistent with myocardial ischemia in patients with peptic ulcer perforation	Upper Gastrointestinal Endoscopy: Biopsy Esophageal Manometry: To exclude an esophageal motility disorder Esophageal impedance pH testing: Monitors esophageal pH	Upper Gastrointestinal Endoscopy
	Esophagitis^[87]^[88]^[89]	Acute	Variable	Burning Epigastric	+	+	-	+/-	Heartburn Abdominal pain	HIV Immunosuppression	No auscultatory finding	Troponin or other cardiac markers Leukopenia ↓CD4 count Human immunodeficiency virus (HIV) test	ECG is done to rule out acute coronary syndrome	Double-contrast esophageal barium study (esophagography) Endoscopy: Biopsy	Endoscopy
	Esophageal Perforation^[18]	Acute	Minutes to hours	Burning Upper abdominal	-	+/-	+	-	Eating disorders such as bulimia Repeated episodes of retching and vomiting with either recent excessive dietary or alcohol intake Subcutaneous emphysema	Instrumentation/surgery Penetrating or blunt trauma Medications, other ingestions, foreign body Violent retching/vomiting Hernia/intestinal volvulus/obstruction Inflammatory bowel disease Appendicitis Peptic ulcer disease	Mild tachycardia or hypothermia Hamman crunch (crackling sound upon chest auscultation occurs due to pneumomediastinum)	↑Serum amylase ↑C-reactive protein levels	EKG may be indicated to assess for myocardial ischemia due to acute gastrointestinal bleeding, especially if there is coexisting:Cardiovascular disease, significant anemia and advanced age	Plain chest films or chest CT: Pneumomediastinum, Free air under the diaphragm, •Pleural effusion •Pneumothorax (Macklin effect). •Subcutaneous emphysema Plain abdominal films (or abdominal CT scout film):The appearance of pneumoperitoneum -Free air under the diaphragm -Cupola sign (inverted cup) -Rigler sign (double-wall sign) -Psoas sign -Urachus sign	Confirmed by water-soluble contrast esophagram
	Mediastinitis^[90]^[91]^[92]^[93]	Acute, Chronic	Variable	Retrosternal irritation	+/-	+	+	-	Nonspecific	Infection Esophageal perforation Post operative complication	Dysphagia Dysphonia Stridor Hamman sign	Positive organisms in sternal culture Leukocytosis Positive blood cultures	Diffuse ST elevation	CT: Localize the infection and extent of spread MRI: Assesses vascular involvement and complications	CT scan
	Pancreatitis^[94]^[95]^[96]^[97]^[98]	Acute, Chronic	Variable	Epigastric Upper left side of the abdomen Pressure like	-	+	+	+/-	Primary cirrhosis Primary sclerosing cholangitis Cystic fibrosis Autoimmune diseases	Alcohol abuse Smoking Genetic predisposition	Tachypnea Hypoxemia Hypotension Cullen's sign Grey Turner sign	↑Amylase levels ↑Lipase levels ↑ALT ↑ALP Leukocytosis	T-wave inversion ST-segment depression ST-segment elevation rarely Q-waves	CT: focal or diffuse enlargement of the pancreas MRI: Pancreatic enlargement	CT Scan
	IBD^[99]	Acute, Chronic	Variable	Painful bowl movments Bloody diarrhea pus or mucus in the stool Fistula sepsis pseudo memberanous colitis	-	+	+	+	Gastric perforation Colon cancer	Genetic predisposition Alcohol abuse Smoking Microbiata and infections	Hypotension Abdominal tenderness	Electrolyte disturbance Leukocytosis	T-wave inversion ST-segment depression ST-segment elevation rarely Q-waves	CT: Gastrointestinal inflamation	CT Scan Colonoscopy biopsy

References

↑ Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.
↑ Parrillo, Joseph (2013). Critical care medicine principles of diagnosis and management in the adult. Philadelphia, PA: Elsevier/Saunders. ISBN 0323089291.
↑ Lier H, Bernhard M, Hossfeld B (March 2018). "[Hypovolemic and hemorrhagic shock]". Anaesthesist (in German). 67 (3): 225–244. doi:10.1007/s00101-018-0411-z. PMID 29404656.
↑ Kobayashi L, Costantini TW, Coimbra R (December 2012). "Hypovolemic shock resuscitation". Surg. Clin. North Am. 92 (6): 1403–23. doi:10.1016/j.suc.2012.08.006. PMID 23153876.
↑ "Shock: Shock and Fluid Resuscitation: Merck Manual Professional".
↑ Pich H, Heller AR (May 2015). "[Obstructive shock]". Anaesthesist (in German). 64 (5): 403–19. doi:10.1007/s00101-015-0031-9. PMID 25994928.
↑ Dababneh E, Siddique MS. PMID 28613734. Missing or empty |title= (help)
↑ Smith N, Lopez RA, Silberman M. PMID 29261964. Missing or empty |title= (help)
↑ Alyeşil C, Doğan NÖ, Özturan İU, Güney S (June 2017). "Distributive Shock in the Emergency Department: Sepsis, Anaphylaxis, or Capillary Leak Syndrome?". J Emerg Med. 52 (6): e229–e231. doi:10.1016/j.jemermed.2017.01.012. PMID 28238385.
↑ Brown SG (May 2007). "The pathophysiology of shock in anaphylaxis". Immunol Allergy Clin North Am. 27 (2): 165–75, v. doi:10.1016/j.iac.2007.03.003. PMID 17493496.
↑ Parrillo, Joseph E.; Ayres, Stephen M. (1984). Major issues in critical care medicine. Baltimore: William Wilkins. ISBN 0-683-06754-0.
↑ Judith S. Hochman, E. Magnus Ohman (2009). Cardiogenic Shock. Wiley-Blackwell. ISBN 9781405179263.
↑ ^13.0 ^13.1 Svavarsdóttir AE, Jónasson MR, Gudmundsson GH, Fjeldsted K (June 1996). "Chest pain in family practice. Diagnosis and long-term outcome in a community setting". Can Fam Physician. 42: 1122–8. PMC 2146490. PMID 8704488.
↑ ^14.0 ^14.1 Klinkman MS, Stevens D, Gorenflo DW (April 1994). "Episodes of care for chest pain: a preliminary report from MIRNET. Michigan Research Network". J Fam Pract. 38 (4): 345–52. PMID 8163958.
↑ ^15.0 ^15.1 Bösner S, Becker A, Haasenritter J, Abu Hani M, Keller H, Sönnichsen AC, Karatolios K, Schaefer JR, Seitz G, Baum E, Donner-Banzhoff N (2009). "Chest pain in primary care: epidemiology and pre-work-up probabilities". Eur J Gen Pract. 15 (3): 141–6. doi:10.3109/13814780903329528. PMID 19883149.
↑ ^16.0 ^16.1 Ebell MH (March 2011). "Evaluation of chest pain in primary care patients". Am Fam Physician. 83 (5): 603–5. PMID 21391528.
↑ von Kodolitsch Y, Schwartz AG, Nienaber CA (October 2000). "Clinical prediction of acute aortic dissection". Arch. Intern. Med. 160 (19): 2977–82. PMID 11041906.
↑ ^18.0 ^18.1 Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH (May 1989). "Spontaneous rupture of the esophagus: a 30-year experience". Ann. Thorac. Surg. 47 (5): 689–92. PMID 2730190.
↑ Fleet RP, Dupuis G, Marchand A, Burelle D, Beitman BD (October 1994). "Panic disorder, chest pain and coronary artery disease: literature review". Can J Cardiol. 10 (8): 827–34. PMID 7954018.
↑ Bass C, Chambers JB, Kiff P, Cooper D, Gardner WN (December 1988). "Panic anxiety and hyperventilation in patients with chest pain: a controlled study". Q. J. Med. 69 (260): 949–59. PMID 3270082.
↑ Evans DW, Lum LC (January 1977). "Hyperventilation: An important cause of pseudoangina". Lancet. 1 (8004): 155–7. PMID 64694.
↑ Ros E, Armengol X, Grande L, Toledo-Pimentel V, Lacima G, Sanz G (July 1997). "Chest pain at rest in patients with coronary artery disease. Myocardial ischemia, esophageal dysfunction, or panic disorder?". Dig. Dis. Sci. 42 (7): 1344–53. PMID 9246027.
↑ Ben Freedman S, Tennant CC (April 1998). "Panic disorder and coronary artery spasm". Med. J. Aust. 168 (8): 376–7. PMID 9594945.
↑ Smoller JW, Pollack MH, Wassertheil-Smoller S, Jackson RD, Oberman A, Wong ND, Sheps D (October 2007). "Panic attacks and risk of incident cardiovascular events among postmenopausal women in the Women's Health Initiative Observational Study". Arch. Gen. Psychiatry. 64 (10): 1153–60. doi:10.1001/archpsyc.64.10.1153. PMID 17909127.
↑ Mehta NJ, Khan IA (November 2002). "Cardiac Munchausen syndrome". Chest. 122 (5): 1649–53. PMID 12426266.
↑ Swap CJ, Nagurney JT (November 2005). "Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes". JAMA. 294 (20): 2623–9. doi:10.1001/jama.294.20.2623. PMID 16304077.
↑ Marcus GM, Cohen J, Varosy PD, Vessey J, Rose E, Massie BM, Chatterjee K, Waters D (January 2007). "The utility of gestures in patients with chest discomfort". Am. J. Med. 120 (1): 83–9. doi:10.1016/j.amjmed.2006.05.045. PMID 17208083.
↑ Verdon F, Burnand B, Herzig L, Junod M, Pécoud A, Favrat B (September 2007). "Chest wall syndrome among primary care patients: a cohort study". BMC Fam Pract. 8: 51. doi:10.1186/1471-2296-8-51. PMC 2072948. PMID 17850647.
↑ Davies HA, Jones DB, Rhodes J, Newcombe RG (December 1985). "Angina-like esophageal pain: differentiation from cardiac pain by history". J. Clin. Gastroenterol. 7 (6): 477–81. PMID 4086742.
↑ Panju AA, Hemmelgarn BR, Guyatt GH, Simel DL (October 1998). "The rational clinical examination. Is this patient having a myocardial infarction?". JAMA. 280 (14): 1256–63. PMID 9786377.
↑ Berger JP, Buclin T, Haller E, Van Melle G, Yersin B (March 1990). "Right arm involvement and pain extension can help to differentiate coronary diseases from chest pain of other origin: a prospective emergency ward study of 278 consecutive patients admitted for chest pain". J. Intern. Med. 227 (3): 165–72. PMID 2313224.
↑ Yelland MJ (September 2001). "Back, chest and abdominal pain. How good are spinal signs at identifying musculoskeletal causes of back, chest or abdominal pain?". Aust Fam Physician. 30 (9): 908–12. PMID 11676323.
↑ Chan S, Maurice AP, Davies SR, Walters DL (October 2014). "The use of gastrointestinal cocktail for differentiating gastro-oesophageal reflux disease and acute coronary syndrome in the emergency setting: a systematic review". Heart Lung Circ. 23 (10): 913–23. doi:10.1016/j.hlc.2014.03.030. PMID 24791662.
↑ Henrikson CA, Howell EE, Bush DE, Miles JS, Meininger GR, Friedlander T, Bushnell AC, Chandra-Strobos N (December 2003). "Chest pain relief by nitroglycerin does not predict active coronary artery disease". Ann. Intern. Med. 139 (12): 979–86. PMID 14678917.
↑ Pryor DB, Harrell FE, Lee KL, Califf RM, Rosati RA (November 1983). "Estimating the likelihood of significant coronary artery disease". Am. J. Med. 75 (5): 771–80. PMID 6638047.
↑ Buntinx F, Knockaert D, Bruyninckx R, de Blaey N, Aerts M, Knottnerus JA, Delooz H (December 2001). "Chest pain in general practice or in the hospital emergency department: is it the same?". Fam Pract. 18 (6): 586–9. PMID 11739341.
↑ Tierney WM, Roth BJ, Psaty B, McHenry R, Fitzgerald J, Stump DL, Anderson FK, Ryder KW, McDonald CJ, Smith DM (July 1985). "Predictors of myocardial infarction in emergency room patients". Crit. Care Med. 13 (7): 526–31. PMID 4006491.
↑ Sequist TD, Marshall R, Lampert S, Buechler EJ, Lee TH (November 2006). "Missed opportunities in the primary care management of early acute ischemic heart disease". Arch. Intern. Med. 166 (20): 2237–43. doi:10.1001/archinte.166.20.2237. PMID 17101942.
↑ Norell M, Lythall D, Coghlan G, Cheng A, Kushwaha S, Swan J, Ilsley C, Mitchell A (January 1992). "Limited value of the resting electrocardiogram in assessing patients with recent onset chest pain: lessons from a chest pain clinic". Br Heart J. 67 (1): 53–6. PMC 1024701. PMID 1739527.
↑ Law K, Elley R, Tietjens J, Mann S (July 2006). "Troponin testing for chest pain in primary healthcare: a survey of its use by general practitioners in New Zealand". N. Z. Med. J. 119 (1238): U2082. PMID 16868579.
↑ Wilhelmsen L, Rosengren A, Hagman M, Lappas G (July 1998). ""Nonspecific" chest pain associated with high long-term mortality: results from the primary prevention study in Göteborg, Sweden". Clin Cardiol. 21 (7): 477–82. PMID 9669056.
↑ Ruigómez A, Rodríguez LA, Wallander MA, Johansson S, Jones R (April 2006). "Chest pain in general practice: incidence, comorbidity and mortality". Fam Pract. 23 (2): 167–74. doi:10.1093/fampra/cmi124. PMID 16461444.
↑ Robinson JG, Wallace R, Limacher M, Sato A, Cochrane B, Wassertheil-Smoller S, Ockene JK, Blanchette PL, Ko MG (December 2006). "Elderly women diagnosed with nonspecific chest pain may be at increased cardiovascular risk". J Womens Health (Larchmt). 15 (10): 1151–60. doi:10.1089/jwh.2006.15.1151. PMID 17199456.
↑ Geraldine McMahon C, Yates DW, Hollis S (February 2008). "Unexpected mortality in patients discharged from the emergency department following an episode of nontraumatic chest pain". Eur J Emerg Med. 15 (1): 3–8. doi:10.1097/MEJ.0b013e32827b14cd. PMID 18180659.
↑ Yelland M, Cayley WE, Vach W (March 2010). "An algorithm for the diagnosis and management of chest pain in primary care". Med. Clin. North Am. 94 (2): 349–74. doi:10.1016/j.mcna.2010.01.011. PMID 20380960.
↑ Wang WH, Huang JQ, Zheng GF, Wong WM, Lam SK, Karlberg J, Xia HH, Fass R, Wong BC (June 2005). "Is proton pump inhibitor testing an effective approach to diagnose gastroesophageal reflux disease in patients with noncardiac chest pain?: a meta-analysis". Arch. Intern. Med. 165 (11): 1222–8. doi:10.1001/archinte.165.11.1222. PMID 15956000.
↑ Borzecki AM, Pedrosa MC, Prashker MJ (March 2000). "Should noncardiac chest pain be treated empirically? A cost-effectiveness analysis". Arch. Intern. Med. 160 (6): 844–52. PMID 10737285.
↑ Wertli MM, Ruchti KB, Steurer J, Held U (November 2013). "Diagnostic indicators of non-cardiovascular chest pain: a systematic review and meta-analysis". BMC Med. 11: 239. doi:10.1186/1741-7015-11-239. PMC 4226211. PMID 24207111.
↑ Takagi H, Ando T, Umemoto T (November 2017). "Meta-Analysis of Circadian Variation in the Onset of Acute Aortic Dissection". Am. J. Cardiol. 120 (9): 1662–1666. doi:10.1016/j.amjcard.2017.07.067. PMID 28847596.
↑ Kojima S, Sumiyoshi M, Nakata Y, Daida H (March 2002). "Triggers and circadian distribution of the onset of acute aortic dissection". Circ. J. 66 (3): 232–5. PMID 11922269.
↑ Eggebrecht, Holger; Baumgart, Dietrich; Schmermund, Axel; Herold, Ulf; Hunold, Peter; Jakob, Heinz; Erbel, Raimund (2003). "Penetrating atherosclerotic ulcer of the aorta: treatment by endovascular stent-graft placement". Current Opinion in Cardiology. 18 (6): 431–435. doi:10.1097/00001573-200311000-00002. ISSN 0268-4705.
↑ Bossone, Eduardo; LaBounty, Troy M; Eagle, Kim A (2018). "Acute aortic syndromes: diagnosis and management, an update". European Heart Journal. 39 (9): 739–749d. doi:10.1093/eurheartj/ehx319. ISSN 0195-668X.
↑ DeMartino, Randall R.; Sen, Indrani; Huang, Ying; Bower, Thomas C.; Oderich, Gustavo S.; Pochettino, Alberto; Greason, Kevin; Kalra, Manju; Johnstone, Jill; Shuja, Fahad; Harmsen, W. Scott; Macedo, Thanila; Mandrekar, Jay; Chamberlain, Alanna M.; Weiss, Salome; Goodney, Philip P.; Roger, Veronique (2018). "Population-Based Assessment of the Incidence of Aortic Dissection, Intramural Hematoma, and Penetrating Ulcer, and Its Associated Mortality From 1995 to 2015". Circulation: Cardiovascular Quality and Outcomes. 11 (8). doi:10.1161/CIRCOUTCOMES.118.004689. ISSN 1941-7713.
↑ Ewart W (March 1896). "Practical Aids in the Diagnosis of Pericardial Effusion, in Connection with the Question as to Surgical Treatment". Br Med J. 1 (1838): 717–21. PMC 2406464. PMID 20756103.
↑ Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, Brucato A, Gueret P, Klingel K, Lionis C, Maisch B, Mayosi B, Pavie A, Ristić AD, Sabaté Tenas M, Seferovic P, Swedberg K, Tomkowski W, Achenbach S, Agewall S, Al-Attar N, Angel Ferrer J, Arad M, Asteggiano R, Bueno H, Caforio AL, Carerj S, Ceconi C, Evangelista A, Flachskampf F, Giannakoulas G, Gielen S, Habib G, Kolh P, Lambrinou E, Lancellotti P, Lazaros G, Linhart A, Meurin P, Nieman K, Piepoli MF, Price S, Roos-Hesselink J, Roubille F, Ruschitzka F, Sagristà Sauleda J, Sousa-Uva M, Uwe Voigt J, Luis Zamorano J (November 2015). "2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS)". Eur. Heart J. 36 (42): 2921–64. doi:10.1093/eurheartj/ehv318. PMID 26320112.
↑ Dec GW, Palacios IF, Fallon JT, Aretz HT, Mills J, Lee DC, Johnson RA (April 1985). "Active myocarditis in the spectrum of acute dilated cardiomyopathies. Clinical features, histologic correlates, and clinical outcome". N. Engl. J. Med. 312 (14): 885–90. doi:10.1056/NEJM198504043121404. PMID 3974674.
↑ Caforio AL, Calabrese F, Angelini A, Tona F, Vinci A, Bottaro S, Ramondo A, Carturan E, Iliceto S, Thiene G, Daliento L (June 2007). "A prospective study of biopsy-proven myocarditis: prognostic relevance of clinical and aetiopathogenetic features at diagnosis". Eur. Heart J. 28 (11): 1326–33. doi:10.1093/eurheartj/ehm076. PMID 17493945.
↑ Ukena C, Mahfoud F, Kindermann I, Kandolf R, Kindermann M, Böhm M (April 2011). "Prognostic electrocardiographic parameters in patients with suspected myocarditis". Eur. J. Heart Fail. 13 (4): 398–405. doi:10.1093/eurjhf/hfq229. PMID 21239404.
↑ Elliott PM, Kaski JC, Prasad K, Seo H, Slade AK, Goldman JH, McKenna WJ (July 1996). "Chest pain during daily life in patients with hypertrophic cardiomyopathy: an ambulatory electrocardiographic study". Eur. Heart J. 17 (7): 1056–64. PMID 8809524.
↑ Pasternac A, Noble J, Streulens Y, Elie R, Henschke C, Bourassa MG (April 1982). "Pathophysiology of chest pain in patients with cardiomyopathies and normal coronary arteries". Circulation. 65 (4): 778–89. PMID 7199403.
↑ Webb JG, Sasson Z, Rakowski H, Liu P, Wigle ED (January 1990). "Apical hypertrophic cardiomyopathy: clinical follow-up and diagnostic correlates". J. Am. Coll. Cardiol. 15 (1): 83–90. PMID 2295747.
↑ Sharkey SW, Lesser JR, Zenovich AG, Maron MS, Lindberg J, Longe TF, Maron BJ (February 2005). "Acute and reversible cardiomyopathy provoked by stress in women from the United States". Circulation. 111 (4): 472–9. doi:10.1161/01.CIR.0000153801.51470.EB. PMID 15687136.
↑ Krishnamoorthy P, Garg J, Sharma A, Palaniswamy C, Shah N, Lanier G, Patel NC, Lavie CJ, Ahmad H (July 2015). "Gender Differences and Predictors of Mortality in Takotsubo Cardiomyopathy: Analysis from the National Inpatient Sample 2009-2010 Database". Cardiology. 132 (2): 131–136. doi:10.1159/000430782. PMID 26159108.
↑ Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, Cammann VL, Sarcon A, Geyer V, Neumann CA, Seifert B, Hellermann J, Schwyzer M, Eisenhardt K, Jenewein J, Franke J, Katus HA, Burgdorf C, Schunkert H, Moeller C, Thiele H, Bauersachs J, Tschöpe C, Schultheiss HP, Laney CA, Rajan L, Michels G, Pfister R, Ukena C, Böhm M, Erbel R, Cuneo A, Kuck KH, Jacobshagen C, Hasenfuss G, Karakas M, Koenig W, Rottbauer W, Said SM, Braun-Dullaeus RC, Cuculi F, Banning A, Fischer TA, Vasankari T, Airaksinen KE, Fijalkowski M, Rynkiewicz A, Pawlak M, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Franz WM, Empen K, Felix SB, Delmas C, Lairez O, Erne P, Bax JJ, Ford I, Ruschitzka F, Prasad A, Lüscher TF (September 2015). "Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy". N. Engl. J. Med. 373 (10): 929–38. doi:10.1056/NEJMoa1406761. PMID 26332547.
↑ Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, Rihal CS (December 2004). "Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction". Ann. Intern. Med. 141 (11): 858–65. PMID 15583228.
↑ Green SJ, Pizzarello RA, Padmanabhan VT, Ong LY, Hall MH, Tortolani AJ (April 1985). "Relation of angina pectoris to coronary artery disease in aortic valve stenosis". Am. J. Cardiol. 55 (8): 1063–5. PMID 3984868.
↑ Silaruks S, Clark D, Thinkhamrop B, Sia B, Buxton B, Tonkin A (2001). "Angina pectoris and coronary artery disease in severe isolated valvular aortic stenosis". Heart Lung Circ. 10 (1): 14–23. doi:10.1046/j.1444-2892.2001.00060.x. PMID 16352020.
↑ Munt B, Legget ME, Kraft CD, Miyake-Hull CY, Fujioka M, Otto CM (February 1999). "Physical examination in valvular aortic stenosis: correlation with stenosis severity and prediction of clinical outcome". Am. Heart J. 137 (2): 298–306. doi:10.1053/hj.1999.v137.95496. PMID 9924164.
↑ Anker SD, Sharma R (September 2002). "The syndrome of cardiac cachexia". Int. J. Cardiol. 85 (1): 51–66. PMID 12163209.
↑ Horwich TB, Kalantar-Zadeh K, MacLellan RW, Fonarow GC (May 2008). "Albumin levels predict survival in patients with systolic heart failure". Am. Heart J. 155 (5): 883–9. doi:10.1016/j.ahj.2007.11.043. PMID 18440336.
↑ Breathett K, Allen LA, Udelson J, Davis G, Bristow M (October 2016). "Changes in Left Ventricular Ejection Fraction Predict Survival and Hospitalization in Heart Failure With Reduced Ejection Fraction". Circ Heart Fail. 9 (10). doi:10.1161/CIRCHEARTFAILURE.115.002962. PMC 5082710. PMID 27656000.
↑ Stein PD, Beemath A, Matta F, Weg JG, Yusen RD, Hales CA, Hull RD, Leeper KV, Sostman HD, Tapson VF, Buckley JD, Gottschalk A, Goodman LR, Wakefied TW, Woodard PK (October 2007). "Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II". Am. J. Med. 120 (10): 871–9. doi:10.1016/j.amjmed.2007.03.024. PMC 2071924. PMID 17904458.
↑ "Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED)". JAMA. 263 (20): 2753–9. 1990. PMID 2332918.
↑ Bense L, Wiman LG, Hedenstierna G (September 1987). "Onset of symptoms in spontaneous pneumothorax: correlations to physical activity". Eur J Respir Dis. 71 (3): 181–6. PMID 3678419.
↑ Seow A, Kazerooni EA, Pernicano PG, Neary M (February 1996). "Comparison of upright inspiratory and expiratory chest radiographs for detecting pneumothoraces". AJR Am J Roentgenol. 166 (2): 313–6. doi:10.2214/ajr.166.2.8553937. PMID 8553937.
↑ Stark P, Leung A (1996). "Effects of lobar atelectasis on the distribution of pleural effusion and pneumothorax". J Thorac Imaging. 11 (2): 145–9. PMID 8820023.
↑ Jalli R, Sefidbakht S, Jafari SH (April 2013). "Value of ultrasound in diagnosis of pneumothorax: a prospective study". Emerg Radiol. 20 (2): 131–4. doi:10.1007/s10140-012-1091-7. PMID 23179505.
↑ Feinsilver SH, Barrows AA, Braman SS (October 1986). "Fiberoptic bronchoscopy and pleural effusion of unknown origin". Chest. 90 (4): 516–9. PMID 3757561.
↑ Collins TR, Sahn SA (June 1987). "Thoracocentesis. Clinical value, complications, technical problems, and patient experience". Chest. 91 (6): 817–22. PMID 3581930.
↑ Venekamp LN, Velkeniers B, Noppen M (2005). "Does 'idiopathic pleuritis' exist? Natural history of non-specific pleuritis diagnosed after thoracoscopy". Respiration. 72 (1): 74–8. doi:10.1159/000083404. PMID 15753638.
↑ Vichinsky EP, Styles LA, Colangelo LH, Wright EC, Castro O, Nickerson B (March 1997). "Acute chest syndrome in sickle cell disease: clinical presentation and course. Cooperative Study of Sickle Cell Disease". Blood. 89 (5): 1787–92. PMID 9057664.
↑ Castro O, Brambilla DJ, Thorington B, Reindorf CA, Scott RB, Gillette P, Vera JC, Levy PS (July 1994). "The acute chest syndrome in sickle cell disease: incidence and risk factors. The Cooperative Study of Sickle Cell Disease". Blood. 84 (2): 643–9. PMID 7517723.
↑ Vichinsky EP, Neumayr LD, Earles AN, Williams R, Lennette ET, Dean D, Nickerson B, Orringer E, McKie V, Bellevue R, Daeschner C, Manci EA (June 2000). "Causes and outcomes of the acute chest syndrome in sickle cell disease. National Acute Chest Syndrome Study Group". N. Engl. J. Med. 342 (25): 1855–65. doi:10.1056/NEJM200006223422502. PMID 10861320.
↑ Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R (August 2006). "The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus". Am. J. Gastroenterol. 101 (8): 1900–20, quiz 1943. doi:10.1111/j.1572-0241.2006.00630.x. PMID 16928254.
↑ Vakil NB, Traxler B, Levine D (August 2004). "Dysphagia in patients with erosive esophagitis: prevalence, severity, and response to proton pump inhibitor treatment". Clin. Gastroenterol. Hepatol. 2 (8): 665–8. PMID 15290658.
↑ Giannini EG, Zentilin P, Dulbecco P, Vigneri S, Scarlata P, Savarino V (February 2008). "Management strategy for patients with gastroesophageal reflux disease: a comparison between empirical treatment with esomeprazole and endoscopy-oriented treatment". Am. J. Gastroenterol. 103 (2): 267–75. doi:10.1111/j.1572-0241.2007.01659.x. PMID 18289194.
↑ Bott S, Prakash C, McCallum RW (August 1987). "Medication-induced esophageal injury: survey of the literature". Am. J. Gastroenterol. 82 (8): 758–63. PMID 3605035.
↑ Parfitt JR, Jayakumar S, Driman DK (September 2008). "Mycophenolate mofetil-related gastrointestinal mucosal injury: variable injury patterns, including graft-versus-host disease-like changes". Am. J. Surg. Pathol. 32 (9): 1367–72. PMID 18763324.
↑ Jaspersen D (March 2000). "Drug-induced oesophageal disorders: pathogenesis, incidence, prevention and management". Drug Saf. 22 (3): 237–49. PMID 10738847.
↑ Loyd JE, Tillman BF, Atkinson JB, Des Prez RM (September 1988). "Mediastinal fibrosis complicating histoplasmosis". Medicine (Baltimore). 67 (5): 295–310. PMID 3045478.
↑ Feigin DS, Eggleston JC, Siegelman SS (January 1979). "The multiple roentgen manifestations of sclerosing mediastinitis". Johns Hopkins Med J. 144 (1): 1–8. PMID 762913.
↑ Garrett HE, Roper CL (December 1986). "Surgical intervention in histoplasmosis". Ann. Thorac. Surg. 42 (6): 711–22. PMID 3539049.
↑ Sherrick AD, Brown LR, Harms GF, Myers JL (August 1994). "The radiographic findings of fibrosing mediastinitis". Chest. 106 (2): 484–9. PMID 7774324.
↑ Dickson AP, Imrie CW (October 1984). "The incidence and prognosis of body wall ecchymosis in acute pancreatitis". Surg Gynecol Obstet. 159 (4): 343–7. PMID 6237447.
↑ Yadav D, Agarwal N, Pitchumoni CS (June 2002). "A critical evaluation of laboratory tests in acute pancreatitis". Am. J. Gastroenterol. 97 (6): 1309–18. doi:10.1111/j.1572-0241.2002.05766.x. PMID 12094843.
↑ Fortson MR, Freedman SN, Webster PD (December 1995). "Clinical assessment of hyperlipidemic pancreatitis". Am. J. Gastroenterol. 90 (12): 2134–9. PMID 8540502.
↑ Lecesne R, Taourel P, Bret PM, Atri M, Reinhold C (June 1999). "Acute pancreatitis: interobserver agreement and correlation of CT and MR cholangiopancreatography with outcome". Radiology. 211 (3): 727–35. doi:10.1148/radiology.211.3.r99jn08727. PMID 10352598.
↑ Stimac D, Miletić D, Radić M, Krznarić I, Mazur-Grbac M, Perković D, Milić S, Golubović V (May 2007). "The role of nonenhanced magnetic resonance imaging in the early assessment of acute pancreatitis". Am. J. Gastroenterol. 102 (5): 997–1004. doi:10.1111/j.1572-0241.2007.01164.x. PMID 17378903.
↑ Colbert, James F.; Schmidt, Eric P.; Faubel, Sarah; Ginde, Adit A. (2017). "Severe Sepsis Outcomes Among Hospitalizations With Inflammatory Bowel Disease". SHOCK. 47 (2): 128–131. doi:10.1097/SHK.0000000000000742. ISSN 1073-2322.

Template:WikiDoc Sources

[1] Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.

[2] Parrillo, Joseph (2013). Critical care medicine principles of diagnosis and management in the adult. Philadelphia, PA: Elsevier/Saunders. ISBN 0323089291.

[pmid29404656-3] Lier H, Bernhard M, Hossfeld B (March 2018). "[Hypovolemic and hemorrhagic shock]". Anaesthesist (in German). 67 (3): 225–244. doi:10.1007/s00101-018-0411-z. PMID 29404656.

[pmid23153876-4] Kobayashi L, Costantini TW, Coimbra R (December 2012). "Hypovolemic shock resuscitation". Surg. Clin. North Am. 92 (6): 1403–23. doi:10.1016/j.suc.2012.08.006. PMID 23153876.

[urlShock:_Shock_and_Fluid_Resuscitation:_Merck_Manual_Professional-5] "Shock: Shock and Fluid Resuscitation: Merck Manual Professional".

[pmid25994928-6] Pich H, Heller AR (May 2015). "[Obstructive shock]". Anaesthesist (in German). 64 (5): 403–19. doi:10.1007/s00101-015-0031-9. PMID 25994928.

[pmid28613734-7] Dababneh E, Siddique MS. PMID 28613734. Missing or empty |title= (help)

[pmid29261964-8] Smith N, Lopez RA, Silberman M. PMID 29261964. Missing or empty |title= (help)

[pmid28238385-9] Alyeşil C, Doğan NÖ, Özturan İU, Güney S (June 2017). "Distributive Shock in the Emergency Department: Sepsis, Anaphylaxis, or Capillary Leak Syndrome?". J Emerg Med. 52 (6): e229–e231. doi:10.1016/j.jemermed.2017.01.012. PMID 28238385.

[pmid17493496-10] Brown SG (May 2007). "The pathophysiology of shock in anaphylaxis". Immunol Allergy Clin North Am. 27 (2): 165–75, v. doi:10.1016/j.iac.2007.03.003. PMID 17493496.

[isbn0-683-06754-0-11] Parrillo, Joseph E.; Ayres, Stephen M. (1984). Major issues in critical care medicine. Baltimore: William Wilkins. ISBN 0-683-06754-0.

[isbn9781405179263-12] Judith S. Hochman, E. Magnus Ohman (2009). Cardiogenic Shock. Wiley-Blackwell. ISBN 9781405179263.

[pmid8704488-13] 13.0 ^13.1 Svavarsdóttir AE, Jónasson MR, Gudmundsson GH, Fjeldsted K (June 1996). "Chest pain in family practice. Diagnosis and long-term outcome in a community setting". Can Fam Physician. 42: 1122–8. PMC 2146490. PMID 8704488.

[pmid8163958-14] 14.0 ^14.1 Klinkman MS, Stevens D, Gorenflo DW (April 1994). "Episodes of care for chest pain: a preliminary report from MIRNET. Michigan Research Network". J Fam Pract. 38 (4): 345–52. PMID 8163958.

[pmid19883149-15] 15.0 ^15.1 Bösner S, Becker A, Haasenritter J, Abu Hani M, Keller H, Sönnichsen AC, Karatolios K, Schaefer JR, Seitz G, Baum E, Donner-Banzhoff N (2009). "Chest pain in primary care: epidemiology and pre-work-up probabilities". Eur J Gen Pract. 15 (3): 141–6. doi:10.3109/13814780903329528. PMID 19883149.

[pmid21391528-16] 16.0 ^16.1 Ebell MH (March 2011). "Evaluation of chest pain in primary care patients". Am Fam Physician. 83 (5): 603–5. PMID 21391528.

[pmid11041906-17] von Kodolitsch Y, Schwartz AG, Nienaber CA (October 2000). "Clinical prediction of acute aortic dissection". Arch. Intern. Med. 160 (19): 2977–82. PMID 11041906.

[pmid2730190-18] 18.0 ^18.1 Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH (May 1989). "Spontaneous rupture of the esophagus: a 30-year experience". Ann. Thorac. Surg. 47 (5): 689–92. PMID 2730190.

[pmid7954018-19] Fleet RP, Dupuis G, Marchand A, Burelle D, Beitman BD (October 1994). "Panic disorder, chest pain and coronary artery disease: literature review". Can J Cardiol. 10 (8): 827–34. PMID 7954018.

[pmid3270082-20] Bass C, Chambers JB, Kiff P, Cooper D, Gardner WN (December 1988). "Panic anxiety and hyperventilation in patients with chest pain: a controlled study". Q. J. Med. 69 (260): 949–59. PMID 3270082.

[pmid64694-21] Evans DW, Lum LC (January 1977). "Hyperventilation: An important cause of pseudoangina". Lancet. 1 (8004): 155–7. PMID 64694.

[pmid9246027-22] Ros E, Armengol X, Grande L, Toledo-Pimentel V, Lacima G, Sanz G (July 1997). "Chest pain at rest in patients with coronary artery disease. Myocardial ischemia, esophageal dysfunction, or panic disorder?". Dig. Dis. Sci. 42 (7): 1344–53. PMID 9246027.

[pmid9594945-23] Ben Freedman S, Tennant CC (April 1998). "Panic disorder and coronary artery spasm". Med. J. Aust. 168 (8): 376–7. PMID 9594945.

[pmid17909127-24] Smoller JW, Pollack MH, Wassertheil-Smoller S, Jackson RD, Oberman A, Wong ND, Sheps D (October 2007). "Panic attacks and risk of incident cardiovascular events among postmenopausal women in the Women's Health Initiative Observational Study". Arch. Gen. Psychiatry. 64 (10): 1153–60. doi:10.1001/archpsyc.64.10.1153. PMID 17909127.

[pmid12426266-25] Mehta NJ, Khan IA (November 2002). "Cardiac Munchausen syndrome". Chest. 122 (5): 1649–53. PMID 12426266.

[pmid16304077-26] Swap CJ, Nagurney JT (November 2005). "Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes". JAMA. 294 (20): 2623–9. doi:10.1001/jama.294.20.2623. PMID 16304077.

[pmid17208083-27] Marcus GM, Cohen J, Varosy PD, Vessey J, Rose E, Massie BM, Chatterjee K, Waters D (January 2007). "The utility of gestures in patients with chest discomfort". Am. J. Med. 120 (1): 83–9. doi:10.1016/j.amjmed.2006.05.045. PMID 17208083.

[pmid17850647-28] Verdon F, Burnand B, Herzig L, Junod M, Pécoud A, Favrat B (September 2007). "Chest wall syndrome among primary care patients: a cohort study". BMC Fam Pract. 8: 51. doi:10.1186/1471-2296-8-51. PMC 2072948. PMID 17850647.

[pmid4086742-29] Davies HA, Jones DB, Rhodes J, Newcombe RG (December 1985). "Angina-like esophageal pain: differentiation from cardiac pain by history". J. Clin. Gastroenterol. 7 (6): 477–81. PMID 4086742.

[pmid9786377-30] Panju AA, Hemmelgarn BR, Guyatt GH, Simel DL (October 1998). "The rational clinical examination. Is this patient having a myocardial infarction?". JAMA. 280 (14): 1256–63. PMID 9786377.

[pmid2313224-31] Berger JP, Buclin T, Haller E, Van Melle G, Yersin B (March 1990). "Right arm involvement and pain extension can help to differentiate coronary diseases from chest pain of other origin: a prospective emergency ward study of 278 consecutive patients admitted for chest pain". J. Intern. Med. 227 (3): 165–72. PMID 2313224.

[pmid11676323-32] Yelland MJ (September 2001). "Back, chest and abdominal pain. How good are spinal signs at identifying musculoskeletal causes of back, chest or abdominal pain?". Aust Fam Physician. 30 (9): 908–12. PMID 11676323.

[pmid24791662-33] Chan S, Maurice AP, Davies SR, Walters DL (October 2014). "The use of gastrointestinal cocktail for differentiating gastro-oesophageal reflux disease and acute coronary syndrome in the emergency setting: a systematic review". Heart Lung Circ. 23 (10): 913–23. doi:10.1016/j.hlc.2014.03.030. PMID 24791662.

[pmid14678917-34] Henrikson CA, Howell EE, Bush DE, Miles JS, Meininger GR, Friedlander T, Bushnell AC, Chandra-Strobos N (December 2003). "Chest pain relief by nitroglycerin does not predict active coronary artery disease". Ann. Intern. Med. 139 (12): 979–86. PMID 14678917.

[pmid6638047-35] Pryor DB, Harrell FE, Lee KL, Califf RM, Rosati RA (November 1983). "Estimating the likelihood of significant coronary artery disease". Am. J. Med. 75 (5): 771–80. PMID 6638047.

[pmid11739341-36] Buntinx F, Knockaert D, Bruyninckx R, de Blaey N, Aerts M, Knottnerus JA, Delooz H (December 2001). "Chest pain in general practice or in the hospital emergency department: is it the same?". Fam Pract. 18 (6): 586–9. PMID 11739341.

[pmid4006491-37] Tierney WM, Roth BJ, Psaty B, McHenry R, Fitzgerald J, Stump DL, Anderson FK, Ryder KW, McDonald CJ, Smith DM (July 1985). "Predictors of myocardial infarction in emergency room patients". Crit. Care Med. 13 (7): 526–31. PMID 4006491.

[pmid17101942-38] Sequist TD, Marshall R, Lampert S, Buechler EJ, Lee TH (November 2006). "Missed opportunities in the primary care management of early acute ischemic heart disease". Arch. Intern. Med. 166 (20): 2237–43. doi:10.1001/archinte.166.20.2237. PMID 17101942.

[pmid1739527-39] Norell M, Lythall D, Coghlan G, Cheng A, Kushwaha S, Swan J, Ilsley C, Mitchell A (January 1992). "Limited value of the resting electrocardiogram in assessing patients with recent onset chest pain: lessons from a chest pain clinic". Br Heart J. 67 (1): 53–6. PMC 1024701. PMID 1739527.

[pmid16868579-40] Law K, Elley R, Tietjens J, Mann S (July 2006). "Troponin testing for chest pain in primary healthcare: a survey of its use by general practitioners in New Zealand". N. Z. Med. J. 119 (1238): U2082. PMID 16868579.

[pmid9669056-41] Wilhelmsen L, Rosengren A, Hagman M, Lappas G (July 1998). ""Nonspecific" chest pain associated with high long-term mortality: results from the primary prevention study in Göteborg, Sweden". Clin Cardiol. 21 (7): 477–82. PMID 9669056.

[pmid16461444-42] Ruigómez A, Rodríguez LA, Wallander MA, Johansson S, Jones R (April 2006). "Chest pain in general practice: incidence, comorbidity and mortality". Fam Pract. 23 (2): 167–74. doi:10.1093/fampra/cmi124. PMID 16461444.

[pmid17199456-43] Robinson JG, Wallace R, Limacher M, Sato A, Cochrane B, Wassertheil-Smoller S, Ockene JK, Blanchette PL, Ko MG (December 2006). "Elderly women diagnosed with nonspecific chest pain may be at increased cardiovascular risk". J Womens Health (Larchmt). 15 (10): 1151–60. doi:10.1089/jwh.2006.15.1151. PMID 17199456.

[pmid18180659-44] Geraldine McMahon C, Yates DW, Hollis S (February 2008). "Unexpected mortality in patients discharged from the emergency department following an episode of nontraumatic chest pain". Eur J Emerg Med. 15 (1): 3–8. doi:10.1097/MEJ.0b013e32827b14cd. PMID 18180659.

[pmid20380960-45] Yelland M, Cayley WE, Vach W (March 2010). "An algorithm for the diagnosis and management of chest pain in primary care". Med. Clin. North Am. 94 (2): 349–74. doi:10.1016/j.mcna.2010.01.011. PMID 20380960.

[pmid15956000-46] Wang WH, Huang JQ, Zheng GF, Wong WM, Lam SK, Karlberg J, Xia HH, Fass R, Wong BC (June 2005). "Is proton pump inhibitor testing an effective approach to diagnose gastroesophageal reflux disease in patients with noncardiac chest pain?: a meta-analysis". Arch. Intern. Med. 165 (11): 1222–8. doi:10.1001/archinte.165.11.1222. PMID 15956000.

[pmid10737285-47] Borzecki AM, Pedrosa MC, Prashker MJ (March 2000). "Should noncardiac chest pain be treated empirically? A cost-effectiveness analysis". Arch. Intern. Med. 160 (6): 844–52. PMID 10737285.

[pmid24207111-48] Wertli MM, Ruchti KB, Steurer J, Held U (November 2013). "Diagnostic indicators of non-cardiovascular chest pain: a systematic review and meta-analysis". BMC Med. 11: 239. doi:10.1186/1741-7015-11-239. PMC 4226211. PMID 24207111.

[pmid28847596-49] Takagi H, Ando T, Umemoto T (November 2017). "Meta-Analysis of Circadian Variation in the Onset of Acute Aortic Dissection". Am. J. Cardiol. 120 (9): 1662–1666. doi:10.1016/j.amjcard.2017.07.067. PMID 28847596.

[pmid11922269-50] Kojima S, Sumiyoshi M, Nakata Y, Daida H (March 2002). "Triggers and circadian distribution of the onset of acute aortic dissection". Circ. J. 66 (3): 232–5. PMID 11922269.

[EggebrechtBaumgart2003-51] Eggebrecht, Holger; Baumgart, Dietrich; Schmermund, Axel; Herold, Ulf; Hunold, Peter; Jakob, Heinz; Erbel, Raimund (2003). "Penetrating atherosclerotic ulcer of the aorta: treatment by endovascular stent-graft placement". Current Opinion in Cardiology. 18 (6): 431–435. doi:10.1097/00001573-200311000-00002. ISSN 0268-4705.

[BossoneLaBounty2018-52] Bossone, Eduardo; LaBounty, Troy M; Eagle, Kim A (2018). "Acute aortic syndromes: diagnosis and management, an update". European Heart Journal. 39 (9): 739–749d. doi:10.1093/eurheartj/ehx319. ISSN 0195-668X.

[DeMartinoSen2018-53] DeMartino, Randall R.; Sen, Indrani; Huang, Ying; Bower, Thomas C.; Oderich, Gustavo S.; Pochettino, Alberto; Greason, Kevin; Kalra, Manju; Johnstone, Jill; Shuja, Fahad; Harmsen, W. Scott; Macedo, Thanila; Mandrekar, Jay; Chamberlain, Alanna M.; Weiss, Salome; Goodney, Philip P.; Roger, Veronique (2018). "Population-Based Assessment of the Incidence of Aortic Dissection, Intramural Hematoma, and Penetrating Ulcer, and Its Associated Mortality From 1995 to 2015". Circulation: Cardiovascular Quality and Outcomes. 11 (8). doi:10.1161/CIRCOUTCOMES.118.004689. ISSN 1941-7713.

[pmid20756103-54] Ewart W (March 1896). "Practical Aids in the Diagnosis of Pericardial Effusion, in Connection with the Question as to Surgical Treatment". Br Med J. 1 (1838): 717–21. PMC 2406464. PMID 20756103.

[pmid26320112-55] Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, Brucato A, Gueret P, Klingel K, Lionis C, Maisch B, Mayosi B, Pavie A, Ristić AD, Sabaté Tenas M, Seferovic P, Swedberg K, Tomkowski W, Achenbach S, Agewall S, Al-Attar N, Angel Ferrer J, Arad M, Asteggiano R, Bueno H, Caforio AL, Carerj S, Ceconi C, Evangelista A, Flachskampf F, Giannakoulas G, Gielen S, Habib G, Kolh P, Lambrinou E, Lancellotti P, Lazaros G, Linhart A, Meurin P, Nieman K, Piepoli MF, Price S, Roos-Hesselink J, Roubille F, Ruschitzka F, Sagristà Sauleda J, Sousa-Uva M, Uwe Voigt J, Luis Zamorano J (November 2015). "2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS)". Eur. Heart J. 36 (42): 2921–64. doi:10.1093/eurheartj/ehv318. PMID 26320112.

[pmid3974674-56] Dec GW, Palacios IF, Fallon JT, Aretz HT, Mills J, Lee DC, Johnson RA (April 1985). "Active myocarditis in the spectrum of acute dilated cardiomyopathies. Clinical features, histologic correlates, and clinical outcome". N. Engl. J. Med. 312 (14): 885–90. doi:10.1056/NEJM198504043121404. PMID 3974674.

[pmid17493945-57] Caforio AL, Calabrese F, Angelini A, Tona F, Vinci A, Bottaro S, Ramondo A, Carturan E, Iliceto S, Thiene G, Daliento L (June 2007). "A prospective study of biopsy-proven myocarditis: prognostic relevance of clinical and aetiopathogenetic features at diagnosis". Eur. Heart J. 28 (11): 1326–33. doi:10.1093/eurheartj/ehm076. PMID 17493945.

[pmid21239404-58] Ukena C, Mahfoud F, Kindermann I, Kandolf R, Kindermann M, Böhm M (April 2011). "Prognostic electrocardiographic parameters in patients with suspected myocarditis". Eur. J. Heart Fail. 13 (4): 398–405. doi:10.1093/eurjhf/hfq229. PMID 21239404.

[pmid8809524-59] Elliott PM, Kaski JC, Prasad K, Seo H, Slade AK, Goldman JH, McKenna WJ (July 1996). "Chest pain during daily life in patients with hypertrophic cardiomyopathy: an ambulatory electrocardiographic study". Eur. Heart J. 17 (7): 1056–64. PMID 8809524.

[pmid7199403-60] Pasternac A, Noble J, Streulens Y, Elie R, Henschke C, Bourassa MG (April 1982). "Pathophysiology of chest pain in patients with cardiomyopathies and normal coronary arteries". Circulation. 65 (4): 778–89. PMID 7199403.

[pmid2295747-61] Webb JG, Sasson Z, Rakowski H, Liu P, Wigle ED (January 1990). "Apical hypertrophic cardiomyopathy: clinical follow-up and diagnostic correlates". J. Am. Coll. Cardiol. 15 (1): 83–90. PMID 2295747.

[pmid15687136-62] Sharkey SW, Lesser JR, Zenovich AG, Maron MS, Lindberg J, Longe TF, Maron BJ (February 2005). "Acute and reversible cardiomyopathy provoked by stress in women from the United States". Circulation. 111 (4): 472–9. doi:10.1161/01.CIR.0000153801.51470.EB. PMID 15687136.

[pmid26159108-63] Krishnamoorthy P, Garg J, Sharma A, Palaniswamy C, Shah N, Lanier G, Patel NC, Lavie CJ, Ahmad H (July 2015). "Gender Differences and Predictors of Mortality in Takotsubo Cardiomyopathy: Analysis from the National Inpatient Sample 2009-2010 Database". Cardiology. 132 (2): 131–136. doi:10.1159/000430782. PMID 26159108.

[pmid26332547-64] Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, Cammann VL, Sarcon A, Geyer V, Neumann CA, Seifert B, Hellermann J, Schwyzer M, Eisenhardt K, Jenewein J, Franke J, Katus HA, Burgdorf C, Schunkert H, Moeller C, Thiele H, Bauersachs J, Tschöpe C, Schultheiss HP, Laney CA, Rajan L, Michels G, Pfister R, Ukena C, Böhm M, Erbel R, Cuneo A, Kuck KH, Jacobshagen C, Hasenfuss G, Karakas M, Koenig W, Rottbauer W, Said SM, Braun-Dullaeus RC, Cuculi F, Banning A, Fischer TA, Vasankari T, Airaksinen KE, Fijalkowski M, Rynkiewicz A, Pawlak M, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Franz WM, Empen K, Felix SB, Delmas C, Lairez O, Erne P, Bax JJ, Ford I, Ruschitzka F, Prasad A, Lüscher TF (September 2015). "Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy". N. Engl. J. Med. 373 (10): 929–38. doi:10.1056/NEJMoa1406761. PMID 26332547.

[pmid15583228-65] Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, Rihal CS (December 2004). "Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction". Ann. Intern. Med. 141 (11): 858–65. PMID 15583228.

[pmid3984868-66] Green SJ, Pizzarello RA, Padmanabhan VT, Ong LY, Hall MH, Tortolani AJ (April 1985). "Relation of angina pectoris to coronary artery disease in aortic valve stenosis". Am. J. Cardiol. 55 (8): 1063–5. PMID 3984868.

[pmid16352020-67] Silaruks S, Clark D, Thinkhamrop B, Sia B, Buxton B, Tonkin A (2001). "Angina pectoris and coronary artery disease in severe isolated valvular aortic stenosis". Heart Lung Circ. 10 (1): 14–23. doi:10.1046/j.1444-2892.2001.00060.x. PMID 16352020.

[pmid9924164-68] Munt B, Legget ME, Kraft CD, Miyake-Hull CY, Fujioka M, Otto CM (February 1999). "Physical examination in valvular aortic stenosis: correlation with stenosis severity and prediction of clinical outcome". Am. Heart J. 137 (2): 298–306. doi:10.1053/hj.1999.v137.95496. PMID 9924164.

[pmid12163209-69] Anker SD, Sharma R (September 2002). "The syndrome of cardiac cachexia". Int. J. Cardiol. 85 (1): 51–66. PMID 12163209.

[pmid18440336-70] Horwich TB, Kalantar-Zadeh K, MacLellan RW, Fonarow GC (May 2008). "Albumin levels predict survival in patients with systolic heart failure". Am. Heart J. 155 (5): 883–9. doi:10.1016/j.ahj.2007.11.043. PMID 18440336.

[pmid27656000-71] Breathett K, Allen LA, Udelson J, Davis G, Bristow M (October 2016). "Changes in Left Ventricular Ejection Fraction Predict Survival and Hospitalization in Heart Failure With Reduced Ejection Fraction". Circ Heart Fail. 9 (10). doi:10.1161/CIRCHEARTFAILURE.115.002962. PMC 5082710. PMID 27656000.

[pmid17904458-72] Stein PD, Beemath A, Matta F, Weg JG, Yusen RD, Hales CA, Hull RD, Leeper KV, Sostman HD, Tapson VF, Buckley JD, Gottschalk A, Goodman LR, Wakefied TW, Woodard PK (October 2007). "Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II". Am. J. Med. 120 (10): 871–9. doi:10.1016/j.amjmed.2007.03.024. PMC 2071924. PMID 17904458.

[pmid2332918-73] "Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED)". JAMA. 263 (20): 2753–9. 1990. PMID 2332918.

[pmid3678419-74] Bense L, Wiman LG, Hedenstierna G (September 1987). "Onset of symptoms in spontaneous pneumothorax: correlations to physical activity". Eur J Respir Dis. 71 (3): 181–6. PMID 3678419.

[pmid8553937-75] Seow A, Kazerooni EA, Pernicano PG, Neary M (February 1996). "Comparison of upright inspiratory and expiratory chest radiographs for detecting pneumothoraces". AJR Am J Roentgenol. 166 (2): 313–6. doi:10.2214/ajr.166.2.8553937. PMID 8553937.

[pmid8820023-76] Stark P, Leung A (1996). "Effects of lobar atelectasis on the distribution of pleural effusion and pneumothorax". J Thorac Imaging. 11 (2): 145–9. PMID 8820023.

[pmid23179505-77] Jalli R, Sefidbakht S, Jafari SH (April 2013). "Value of ultrasound in diagnosis of pneumothorax: a prospective study". Emerg Radiol. 20 (2): 131–4. doi:10.1007/s10140-012-1091-7. PMID 23179505.

[pmid3757561-78] Feinsilver SH, Barrows AA, Braman SS (October 1986). "Fiberoptic bronchoscopy and pleural effusion of unknown origin". Chest. 90 (4): 516–9. PMID 3757561.

[pmid3581930-79] Collins TR, Sahn SA (June 1987). "Thoracocentesis. Clinical value, complications, technical problems, and patient experience". Chest. 91 (6): 817–22. PMID 3581930.

[pmid15753638-80] Venekamp LN, Velkeniers B, Noppen M (2005). "Does 'idiopathic pleuritis' exist? Natural history of non-specific pleuritis diagnosed after thoracoscopy". Respiration. 72 (1): 74–8. doi:10.1159/000083404. PMID 15753638.

[pmid9057664-81] Vichinsky EP, Styles LA, Colangelo LH, Wright EC, Castro O, Nickerson B (March 1997). "Acute chest syndrome in sickle cell disease: clinical presentation and course. Cooperative Study of Sickle Cell Disease". Blood. 89 (5): 1787–92. PMID 9057664.

[pmid7517723-82] Castro O, Brambilla DJ, Thorington B, Reindorf CA, Scott RB, Gillette P, Vera JC, Levy PS (July 1994). "The acute chest syndrome in sickle cell disease: incidence and risk factors. The Cooperative Study of Sickle Cell Disease". Blood. 84 (2): 643–9. PMID 7517723.

[pmid10861320-83] Vichinsky EP, Neumayr LD, Earles AN, Williams R, Lennette ET, Dean D, Nickerson B, Orringer E, McKie V, Bellevue R, Daeschner C, Manci EA (June 2000). "Causes and outcomes of the acute chest syndrome in sickle cell disease. National Acute Chest Syndrome Study Group". N. Engl. J. Med. 342 (25): 1855–65. doi:10.1056/NEJM200006223422502. PMID 10861320.

[pmid16928254-84] Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R (August 2006). "The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus". Am. J. Gastroenterol. 101 (8): 1900–20, quiz 1943. doi:10.1111/j.1572-0241.2006.00630.x. PMID 16928254.

[pmid15290658-85] Vakil NB, Traxler B, Levine D (August 2004). "Dysphagia in patients with erosive esophagitis: prevalence, severity, and response to proton pump inhibitor treatment". Clin. Gastroenterol. Hepatol. 2 (8): 665–8. PMID 15290658.

[pmid18289194-86] Giannini EG, Zentilin P, Dulbecco P, Vigneri S, Scarlata P, Savarino V (February 2008). "Management strategy for patients with gastroesophageal reflux disease: a comparison between empirical treatment with esomeprazole and endoscopy-oriented treatment". Am. J. Gastroenterol. 103 (2): 267–75. doi:10.1111/j.1572-0241.2007.01659.x. PMID 18289194.

[pmid3605035-87] Bott S, Prakash C, McCallum RW (August 1987). "Medication-induced esophageal injury: survey of the literature". Am. J. Gastroenterol. 82 (8): 758–63. PMID 3605035.

[pmid18763324-88] Parfitt JR, Jayakumar S, Driman DK (September 2008). "Mycophenolate mofetil-related gastrointestinal mucosal injury: variable injury patterns, including graft-versus-host disease-like changes". Am. J. Surg. Pathol. 32 (9): 1367–72. PMID 18763324.

[pmid10738847-89] Jaspersen D (March 2000). "Drug-induced oesophageal disorders: pathogenesis, incidence, prevention and management". Drug Saf. 22 (3): 237–49. PMID 10738847.

[pmid3045478-90] Loyd JE, Tillman BF, Atkinson JB, Des Prez RM (September 1988). "Mediastinal fibrosis complicating histoplasmosis". Medicine (Baltimore). 67 (5): 295–310. PMID 3045478.

[pmid762913-91] Feigin DS, Eggleston JC, Siegelman SS (January 1979). "The multiple roentgen manifestations of sclerosing mediastinitis". Johns Hopkins Med J. 144 (1): 1–8. PMID 762913.

[pmid3539049-92] Garrett HE, Roper CL (December 1986). "Surgical intervention in histoplasmosis". Ann. Thorac. Surg. 42 (6): 711–22. PMID 3539049.

[pmid7774324-93] Sherrick AD, Brown LR, Harms GF, Myers JL (August 1994). "The radiographic findings of fibrosing mediastinitis". Chest. 106 (2): 484–9. PMID 7774324.

[pmid6237447-94] Dickson AP, Imrie CW (October 1984). "The incidence and prognosis of body wall ecchymosis in acute pancreatitis". Surg Gynecol Obstet. 159 (4): 343–7. PMID 6237447.

[pmid12094843-95] Yadav D, Agarwal N, Pitchumoni CS (June 2002). "A critical evaluation of laboratory tests in acute pancreatitis". Am. J. Gastroenterol. 97 (6): 1309–18. doi:10.1111/j.1572-0241.2002.05766.x. PMID 12094843.

[pmid8540502-96] Fortson MR, Freedman SN, Webster PD (December 1995). "Clinical assessment of hyperlipidemic pancreatitis". Am. J. Gastroenterol. 90 (12): 2134–9. PMID 8540502.

[pmid10352598-97] Lecesne R, Taourel P, Bret PM, Atri M, Reinhold C (June 1999). "Acute pancreatitis: interobserver agreement and correlation of CT and MR cholangiopancreatography with outcome". Radiology. 211 (3): 727–35. doi:10.1148/radiology.211.3.r99jn08727. PMID 10352598.

[pmid17378903-98] Stimac D, Miletić D, Radić M, Krznarić I, Mazur-Grbac M, Perković D, Milić S, Golubović V (May 2007). "The role of nonenhanced magnetic resonance imaging in the early assessment of acute pancreatitis". Am. J. Gastroenterol. 102 (5): 997–1004. doi:10.1111/j.1572-0241.2007.01164.x. PMID 17378903.

[ColbertSchmidt2017-99] Colbert, James F.; Schmidt, Eric P.; Faubel, Sarah; Ginde, Adit A. (2017). "Severe Sepsis Outcomes Among Hospitalizations With Inflammatory Bowel Disease". SHOCK. 47 (2): 128–131. doi:10.1097/SHK.0000000000000742. ISSN 1073-2322.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]

[27]

[28]

[29]

[30]

[31]

[32]

[33]

[34]

[35]

[36]

[37]

[38]

[39]

[40]

[41]

[42]

[43]

[44]

[45]

[46]

[47]

[48]

[49]

[50]

[51]

[52]

[53]

[54]

[55]

[56]

[57]

[58]

[59]

[60]

[61]

[62]

[63]

[64]

[65]

[66]

[67]

[68]

[69]

[70]

[71]

[72]

[73]

[74]

[75]

[76]

[77]

[78]

[79]

[80]

[81]

[82]

[83]

[84]

[85]

[86]

[87]

[88]

[89]

[90]

[91]

[92]

[93]

[94]

[95]

[96]

[97]

[98]

[99]

@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Cardiogenic shock}}
+[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Cardiogenic_shock]]
-{{CMG}}; {{AE}} {{JS}} {{sali}}
+{{CMG}}; {{AE}} {{JS}} {{sali}} {{RG}}
 ==Overview==
@@ Line 11: / Line 11: @@
 ::*More than a simple loss of [[intravascular]] volume, [[hypovolemic shock]] is a dynamic process in which the responses to the initial insult, and the period of time during which they are in practice, will dictate the response to treatment and therefore the [[outcome]]. Several causes may be in the origin of this type of [[shock]], including: [[hemorrhage]], [[dehydration]], [[GI]] or [[urinary]] losses and severe [[vasodilation|venodilation]] (in the setting of other conditions). There is a relationship between the clinical status of the patient and the amount of circulating [[blood]] volume, the [[signs]] may include  [[pallor]], [[cool extremities]], [[tachycardia]] and [[tachypnea]], [[oliguria]] and decreased [[consciousness]]. Compensatory mechanisms are responsible for tolerating initial [[blood loss]], however they begin to fail after about 20-25% of [[blood]] has been lost. This tolerance will be dictated mostly by the previous [[cardiac]] reserve of the patient, along with the velocity of loss of [[intravascular]] volume<ref name="pmid29404656">{{cite journal |vauthors=Lier H, Bernhard M, Hossfeld B |title=[Hypovolemic and hemorrhagic shock] |language=German |journal=Anaesthesist |volume=67 |issue=3 |pages=225–244 |date=March 2018 |pmid=29404656 |doi=10.1007/s00101-018-0411-z |url=}}</ref><ref name="pmid23153876">{{cite journal |vauthors=Kobayashi L, Costantini TW, Coimbra R |title=Hypovolemic shock resuscitation |journal=Surg. Clin. North Am. |volume=92 |issue=6 |pages=1403–23 |date=December 2012 |pmid=23153876 |doi=10.1016/j.suc.2012.08.006 |url=}}</ref>.
 ::*When comparing [[hypovolemic shock|hypovolemic]] and [[cardiogenic shock]] (most commonly complicating acute-[[MI]]) some specific clinical [[signs]] of [[shock]] will be similar, however, others will be different, particularly [[signs]] of [[CHF]], such as the presence of distended [[jugular]] and peripheral [[veins]], presence of an [[S3]] sound and [[pulmonary edema]] on the cardiogenic type.
-::*When comparing [[hemodynamic]] data, similarities include: decreased [[cardiac index]], [[stroke volume]] index, [[cardiac output]], mixed [[venous]] [[oxygen saturation]] and increased difference in arteriovenous O<sub>2</sub> saturation and [[SVR]]. Differences to be noted include: decreased [[ventricular]] [[preload]], [[ventricular]] [[diastolic]] volumes and pressures, [[pulmonary wedge pressure]] and [[central venous pressure]].
+::*When comparing [[hemodynamic]] data, similarities include: decreased [[cardiac index]], [[stroke volume]] index, [[cardiac output]], mixed [[venous]] [[oxygen saturation]] and increased difference in arteriovenous O<sub>2</sub> saturation and [[SVR]].
+Differences to be noted include:
+:<math>\mbox{Shock index} = \frac{heart\ rate}{systolic\ blood\ pressure}</math>
+Other measures include:
+decreased [[ventricular]] [[preload]], [[ventricular]] [[diastolic]] volumes and pressures, [[pulmonary wedge pressure]] and [[central venous pressure]].
 ::*When treating [[hypovolemic shock]] it's mandatory to rule out [[cardiogenic]] cause because part of the treatment for [[hypovolemic shock]], urgent [[intravascular]] volume replacement, may further jeopardize the [[cardiac]] condition in the cardiogenic form.
@@ Line 21: / Line 26: @@
 ::*The hallmark of this form of [[shock]] is the decrease of [[peripheral resistance]]. This may be present in a series of conditions that may lead to [[distributive shock]], such as: [[sepsis]], [[anaphylaxis]], [[toxic shock syndrome]] and [[adrenal crisis]].
 ::*When compared to [[cardiogenic shock]] it presents with similarities, such as: decreased [[cardiac index]], left and right [[ventricular]] stroke work and increased [[serum]] [[lactate]]. The differences reside in: overall decreased of [[SVR]], which after fluid resuscitation may become elevated, [[ventricular]] filling pressure, difference in arteriovenous O<sub>2</sub> saturation and increase of mixed [[venous]] [[oxygen saturation]]. It is important to note that, unlike [[cardiogenic shock|cardiogenic]] and other types of [[shock]], in the [[distributive shock|distributive]] kind there is an increase in [[venous]] [[oxygen saturation]] which, despite the increased O<sub>2</sub> demand, might be due to the increased total body [[perfusion]], that is responsible for diminishing the effectiveness of individual tissue [[perfusion]]<ref name="pmid29261964">{{cite journal |vauthors=Smith N, Lopez RA, Silberman M |title= |journal= |volume= |issue= |pages= |date= |pmid=29261964 |doi= |url=}}</ref><ref name="pmid28238385">{{cite journal |vauthors=Alyeşil C, Doğan NÖ, Özturan İU, Güney S |title=Distributive Shock in the Emergency Department: Sepsis, Anaphylaxis, or Capillary Leak Syndrome? |journal=J Emerg Med |volume=52 |issue=6 |pages=e229–e231 |date=June 2017 |pmid=28238385 |doi=10.1016/j.jemermed.2017.01.012 |url=}}</ref><ref name="pmid17493496">{{cite journal |vauthors=Brown SG |title=The pathophysiology of shock in anaphylaxis |journal=Immunol Allergy Clin North Am |volume=27 |issue=2 |pages=165–75, v |date=May 2007 |pmid=17493496 |doi=10.1016/j.iac.2007.03.003 |url=}}</ref>.
+<small><small>
 {| style="border: 8px solid #A8A8A8; font-size: 180%;" align="center"
-|+ <SMALL>''Classification of shock based on hemodynamic parameters.'' (CO, cardiac output; CVP; central venous pressure; PAD, pulmonary artery diastolic pressure; PAS, pulmonary artery systolic pressure; RVD, right ventricular diastolic pressure; RVS, right ventricular systolic pressure; SVO2, systemic venous oxygen saturation; SVR, systemic vascular resistance.)<ref name="isbn0-683-06754-0">{{Cite book  | last1 = Parrillo | first1 = Joseph E. | last2 = Ayres | first2 = Stephen M. | title = Major issues in critical care medicine | date = 1984 | publisher = William  Wilkins | location = Baltimore | isbn = 0-683-06754-0 | pages =  }}</ref><ref name="isbn9781405179263">{{cite book | author = Judith S. Hochman, E. Magnus Ohman | authorlink = | editor = | others = | title = Cardiogenic Shock | edition = | language = | publisher = Wiley-Blackwell | location = | year = 2009 | origyear = | pages = | quote = | isbn = 9781405179263 | oclc = | doi = | url = | accessdate = }}</ref></SMALL>
+|+ ''Classification of shock based on hemodynamic parameters.'' (CO, cardiac output; CVP; central venous pressure; PAD, pulmonary artery diastolic pressure; PAS, pulmonary artery systolic pressure; RVD, right ventricular diastolic pressure; RVS, right ventricular systolic pressure; SVO2, systemic venous oxygen saturation; SVR, systemic vascular resistance.)<ref name="isbn0-683-06754-0">{{Cite book  | last1 = Parrillo | first1 = Joseph E. | last2 = Ayres | first2 = Stephen M. | title = Major issues in critical care medicine | date = 1984 | publisher = William  Wilkins | location = Baltimore | isbn = 0-683-06754-0 | pages =  }}</ref><ref name="isbn9781405179263">{{cite book | author = Judith S. Hochman, E. Magnus Ohman | authorlink = | editor = | others = | title = Cardiogenic Shock | edition = | language = | publisher = Wiley-Blackwell | location = | year = 2009 | origyear = | pages = | quote = | isbn = 9781405179263 | oclc = | doi = | url = | accessdate = }}</ref>
 | align="center" style="background: #A8A8A8; width: 100px;"| '''Type of Shock'''
 | align="center" style="background: #A8A8A8; width: 50px;" | '''Etiology'''
@@ Line 143: / Line 148: @@
 '''The following table outlines the major differential diagnoses of Shock on the basis of clinical manifestations.'''.<ref name="pmid8704488">{{cite journal |vauthors=Svavarsdóttir AE, Jónasson MR, Gudmundsson GH, Fjeldsted K |title=Chest pain in family practice. Diagnosis and long-term outcome in a community setting |journal=Can Fam Physician |volume=42 |issue= |pages=1122–8 |date=June 1996 |pmid=8704488 |pmc=2146490 |doi= |url=}}</ref><ref name="pmid8163958">{{cite journal |vauthors=Klinkman MS, Stevens D, Gorenflo DW |title=Episodes of care for chest pain: a preliminary report from MIRNET. Michigan Research Network |journal=J Fam Pract |volume=38 |issue=4 |pages=345–52 |date=April 1994 |pmid=8163958 |doi= |url=}}</ref><ref name="pmid19883149">{{cite journal |vauthors=Bösner S, Becker A, Haasenritter J, Abu Hani M, Keller H, Sönnichsen AC, Karatolios K, Schaefer JR, Seitz G, Baum E, Donner-Banzhoff N |title=Chest pain in primary care: epidemiology and pre-work-up probabilities |journal=Eur J Gen Pract |volume=15 |issue=3 |pages=141–6 |date= 2009 |pmid=19883149 |doi=10.3109/13814780903329528 |url=}}</ref><ref name="pmid21391528">{{cite journal |vauthors=Ebell MH |title=Evaluation of chest pain in primary care patients |journal=Am Fam Physician |volume=83 |issue=5 |pages=603–5 |date=March 2011 |pmid=21391528 |doi= |url=}}</ref><ref name="pmid11041906">{{cite journal |vauthors=von Kodolitsch Y, Schwartz AG, Nienaber CA |title=Clinical prediction of acute aortic dissection |journal=Arch. Intern. Med. |volume=160 |issue=19 |pages=2977–82 |date=October 2000 |pmid=11041906 |doi= |url=}}</ref><ref name="pmid2730190">{{cite journal |vauthors=Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH |title=Spontaneous rupture of the esophagus: a 30-year experience |journal=Ann. Thorac. Surg. |volume=47 |issue=5 |pages=689–92 |date=May 1989 |pmid=2730190 |doi= |url=}}</ref><ref name="pmid7954018">{{cite journal |vauthors=Fleet RP, Dupuis G, Marchand A, Burelle D, Beitman BD |title=Panic disorder, chest pain and coronary artery disease: literature review |journal=Can J Cardiol |volume=10 |issue=8 |pages=827–34 |date=October 1994 |pmid=7954018 |doi= |url=}}</ref><ref name="pmid3270082">{{cite journal |vauthors=Bass C, Chambers JB, Kiff P, Cooper D, Gardner WN |title=Panic anxiety and hyperventilation in patients with chest pain: a controlled study |journal=Q. J. Med. |volume=69 |issue=260 |pages=949–59 |date=December 1988 |pmid=3270082 |doi= |url=}}</ref><ref name="pmid64694">{{cite journal |vauthors=Evans DW, Lum LC |title=Hyperventilation: An important cause of pseudoangina |journal=Lancet |volume=1 |issue=8004 |pages=155–7 |date=January 1977 |pmid=64694 |doi= |url=}}</ref><ref name="pmid9246027">{{cite journal |vauthors=Ros E, Armengol X, Grande L, Toledo-Pimentel V, Lacima G, Sanz G |title=Chest pain at rest in patients with coronary artery disease. Myocardial ischemia, esophageal dysfunction, or panic disorder? |journal=Dig. Dis. Sci. |volume=42 |issue=7 |pages=1344–53 |date=July 1997 |pmid=9246027 |doi= |url=}}</ref><ref name="pmid9594945">{{cite journal |vauthors=Ben Freedman S, Tennant CC |title=Panic disorder and coronary artery spasm |journal=Med. J. Aust. |volume=168 |issue=8 |pages=376–7 |date=April 1998 |pmid=9594945 |doi= |url=}}</ref><ref name="pmid17909127">{{cite journal |vauthors=Smoller JW, Pollack MH, Wassertheil-Smoller S, Jackson RD, Oberman A, Wong ND, Sheps D |title=Panic attacks and risk of incident cardiovascular events among postmenopausal women in the Women's Health Initiative Observational Study |journal=Arch. Gen. Psychiatry |volume=64 |issue=10 |pages=1153–60 |date=October 2007 |pmid=17909127 |doi=10.1001/archpsyc.64.10.1153 |url=}}</ref><ref name="pmid12426266">{{cite journal |vauthors=Mehta NJ, Khan IA |title=Cardiac Munchausen syndrome |journal=Chest |volume=122 |issue=5 |pages=1649–53 |date=November 2002 |pmid=12426266 |doi= |url=}}</ref><ref name="pmid16304077">{{cite journal |vauthors=Swap CJ, Nagurney JT |title=Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes |journal=JAMA |volume=294 |issue=20 |pages=2623–9 |date=November 2005 |pmid=16304077 |doi=10.1001/jama.294.20.2623 |url=}}</ref><ref name="pmid17208083">{{cite journal |vauthors=Marcus GM, Cohen J, Varosy PD, Vessey J, Rose E, Massie BM, Chatterjee K, Waters D |title=The utility of gestures in patients with chest discomfort |journal=Am. J. Med. |volume=120 |issue=1 |pages=83–9 |date=January 2007 |pmid=17208083 |doi=10.1016/j.amjmed.2006.05.045 |url=}}</ref><ref name="pmid17850647">{{cite journal |vauthors=Verdon F, Burnand B, Herzig L, Junod M, Pécoud A, Favrat B |title=Chest wall syndrome among primary care patients: a cohort study |journal=BMC Fam Pract |volume=8 |issue= |pages=51 |date=September 2007 |pmid=17850647 |pmc=2072948 |doi=10.1186/1471-2296-8-51 |url=}}</ref><ref name="pmid4086742">{{cite journal |vauthors=Davies HA, Jones DB, Rhodes J, Newcombe RG |title=Angina-like esophageal pain: differentiation from cardiac pain by history |journal=J. Clin. Gastroenterol. |volume=7 |issue=6 |pages=477–81 |date=December 1985 |pmid=4086742 |doi= |url=}}</ref><ref name="pmid9786377">{{cite journal |vauthors=Panju AA, Hemmelgarn BR, Guyatt GH, Simel DL |title=The rational clinical examination. Is this patient having a myocardial infarction? |journal=JAMA |volume=280 |issue=14 |pages=1256–63 |date=October 1998 |pmid=9786377 |doi= |url=}}</ref><ref name="pmid2313224">{{cite journal |vauthors=Berger JP, Buclin T, Haller E, Van Melle G, Yersin B |title=Right arm involvement and pain extension can help to differentiate coronary diseases from chest pain of other origin: a prospective emergency ward study of 278 consecutive patients admitted for chest pain |journal=J. Intern. Med. |volume=227 |issue=3 |pages=165–72 |date=March 1990 |pmid=2313224 |doi= |url=}}</ref><ref name="pmid11676323">{{cite journal |vauthors=Yelland MJ |title=Back, chest and abdominal pain. How good are spinal signs at identifying musculoskeletal causes of back, chest or abdominal pain? |journal=Aust Fam Physician |volume=30 |issue=9 |pages=908–12 |date=September 2001 |pmid=11676323 |doi= |url=}}</ref><ref name="pmid24791662">{{cite journal |vauthors=Chan S, Maurice AP, Davies SR, Walters DL |title=The use of gastrointestinal cocktail for differentiating gastro-oesophageal reflux disease and acute coronary syndrome in the emergency setting: a systematic review |journal=Heart Lung Circ |volume=23 |issue=10 |pages=913–23 |date=October 2014 |pmid=24791662 |doi=10.1016/j.hlc.2014.03.030 |url=}}</ref><ref name="pmid14678917">{{cite journal |vauthors=Henrikson CA, Howell EE, Bush DE, Miles JS, Meininger GR, Friedlander T, Bushnell AC, Chandra-Strobos N |title=Chest pain relief by nitroglycerin does not predict active coronary artery disease |journal=Ann. Intern. Med. |volume=139 |issue=12 |pages=979–86 |date=December 2003 |pmid=14678917 |doi= |url=}}</ref><ref name="pmid6638047">{{cite journal |vauthors=Pryor DB, Harrell FE, Lee KL, Califf RM, Rosati RA |title=Estimating the likelihood of significant coronary artery disease |journal=Am. J. Med. |volume=75 |issue=5 |pages=771–80 |date=November 1983 |pmid=6638047 |doi= |url=}}</ref><ref name="pmid11739341">{{cite journal |vauthors=Buntinx F, Knockaert D, Bruyninckx R, de Blaey N, Aerts M, Knottnerus JA, Delooz H |title=Chest pain in general practice or in the hospital emergency department: is it the same? |journal=Fam Pract |volume=18 |issue=6 |pages=586–9 |date=December 2001 |pmid=11739341 |doi= |url=}}</ref><ref name="pmid4006491">{{cite journal |vauthors=Tierney WM, Roth BJ, Psaty B, McHenry R, Fitzgerald J, Stump DL, Anderson FK, Ryder KW, McDonald CJ, Smith DM |title=Predictors of myocardial infarction in emergency room patients |journal=Crit. Care Med. |volume=13 |issue=7 |pages=526–31 |date=July 1985 |pmid=4006491 |doi= |url=}}</ref><ref name="pmid17101942">{{cite journal |vauthors=Sequist TD, Marshall R, Lampert S, Buechler EJ, Lee TH |title=Missed opportunities in the primary care management of early acute ischemic heart disease |journal=Arch. Intern. Med. |volume=166 |issue=20 |pages=2237–43 |date=November 2006 |pmid=17101942 |doi=10.1001/archinte.166.20.2237 |url=}}</ref><ref name="pmid1739527">{{cite journal |vauthors=Norell M, Lythall D, Coghlan G, Cheng A, Kushwaha S, Swan J, Ilsley C, Mitchell A |title=Limited value of the resting electrocardiogram in assessing patients with recent onset chest pain: lessons from a chest pain clinic |journal=Br Heart J |volume=67 |issue=1 |pages=53–6 |date=January 1992 |pmid=1739527 |pmc=1024701 |doi= |url=}}</ref><ref name="pmid16868579">{{cite journal |vauthors=Law K, Elley R, Tietjens J, Mann S |title=Troponin testing for chest pain in primary healthcare: a survey of its use by general practitioners in New Zealand |journal=N. Z. Med. J. |volume=119 |issue=1238 |pages=U2082 |date=July 2006 |pmid=16868579 |doi= |url=}}</ref><ref name="pmid9669056">{{cite journal |vauthors=Wilhelmsen L, Rosengren A, Hagman M, Lappas G |title="Nonspecific" chest pain associated with high long-term mortality: results from the primary prevention study in Göteborg, Sweden |journal=Clin Cardiol |volume=21 |issue=7 |pages=477–82 |date=July 1998 |pmid=9669056 |doi= |url=}}</ref><ref name="pmid16461444">{{cite journal |vauthors=Ruigómez A, Rodríguez LA, Wallander MA, Johansson S, Jones R |title=Chest pain in general practice: incidence, comorbidity and mortality |journal=Fam Pract |volume=23 |issue=2 |pages=167–74 |date=April 2006 |pmid=16461444 |doi=10.1093/fampra/cmi124 |url=}}</ref><ref name="pmid17199456">{{cite journal |vauthors=Robinson JG, Wallace R, Limacher M, Sato A, Cochrane B, Wassertheil-Smoller S, Ockene JK, Blanchette PL, Ko MG |title=Elderly women diagnosed with nonspecific chest pain may be at increased cardiovascular risk |journal=J Womens Health (Larchmt) |volume=15 |issue=10 |pages=1151–60 |date=December 2006 |pmid=17199456 |doi=10.1089/jwh.2006.15.1151 |url=}}</ref><ref name="pmid18180659">{{cite journal |vauthors=Geraldine McMahon C, Yates DW, Hollis S |title=Unexpected mortality in patients discharged from the emergency department following an episode of nontraumatic chest pain |journal=Eur J Emerg Med |volume=15 |issue=1 |pages=3–8 |date=February 2008 |pmid=18180659 |doi=10.1097/MEJ.0b013e32827b14cd |url=}}</ref><ref name="pmid20380960">{{cite journal |vauthors=Yelland M, Cayley WE, Vach W |title=An algorithm for the diagnosis and management of chest pain in primary care |journal=Med. Clin. North Am. |volume=94 |issue=2 |pages=349–74 |date=March 2010 |pmid=20380960 |doi=10.1016/j.mcna.2010.01.011 |url=}}</ref><ref name="pmid15956000">{{cite journal |vauthors=Wang WH, Huang JQ, Zheng GF, Wong WM, Lam SK, Karlberg J, Xia HH, Fass R, Wong BC |title=Is proton pump inhibitor testing an effective approach to diagnose gastroesophageal reflux disease in patients with noncardiac chest pain?: a meta-analysis |journal=Arch. Intern. Med. |volume=165 |issue=11 |pages=1222–8 |date=June 2005 |pmid=15956000 |doi=10.1001/archinte.165.11.1222 |url=}}</ref><ref name="pmid10737285">{{cite journal |vauthors=Borzecki AM, Pedrosa MC, Prashker MJ |title=Should noncardiac chest pain be treated empirically? A cost-effectiveness analysis |journal=Arch. Intern. Med. |volume=160 |issue=6 |pages=844–52 |date=March 2000 |pmid=10737285 |doi= |url=}}</ref><ref name="pmid24207111">{{cite journal |vauthors=Wertli MM, Ruchti KB, Steurer J, Held U |title=Diagnostic indicators of non-cardiovascular chest pain: a systematic review and meta-analysis |journal=BMC Med |volume=11 |issue= |pages=239 |date=November 2013 |pmid=24207111 |pmc=4226211 |doi=10.1186/1741-7015-11-239 |url=}}</ref>
-<small><small>
 '''''Abbreviations:''''' '''ABG ('''[[arterial blood gas]]'''); ACE ('''[[Angiotensin-converting enzyme|angiotensin converting enzyme]]'''); BMI ('''[[body mass index]]'''); CBC ('''[[Complete blood counts|complete blood count]]'''); CSF ('''[[cerebrospinal fluid]]'''); CXR ('''[[chest X-ray]]'''); ECG ('''[[electrocardiogram]]'''); FEF ('''[[Spirometry|forced expiratory flow rate]]'''); FEV1 ('''[[forced expiratory volume]]'''); FVC ('''[[forced vital capacity]]'''); JVD ('''[[jugular vein distention]]''');''' '''MCV ('''[[mean corpuscular volume]]'''); Plt ('''[[platelet]]'''); RV ('''[[residual volume]]'''); SIADH ('''[[syndrome of inappropriate antidiuretic hormone]]'''); TSH ('''[[thyroid stimulating hormone]]'''); Vt ('''[[tidal volume]]''');''' '''WBC ('''[[White blood cells|white blood cell]]'''); Coronary CT angiography (CCTA); multidetector row scanners (MDCT); Cardiovascular magnetic resonance — CMRI; Myocardial perfusion imaging (MPI); single-photon emission CT (SPECT); Positron emission tomography (PET) scanning; Magnetic resonance (MR) angiography, Computed tomographic (CT) angiography, and Transesophageal echocardiography (TEE), late gadolinium enhancement (LGE); right ventricular hypertrophy (RVH), right atrial enlargement (RAE), functional tricuspid regurgitation (TR), Pulmonary artery systolic pressure (PASP; adenosine deaminase (ADA); Serum amyloid A (SAA), soluble interleukin-2 receptor (sIL2R); High-resolution CT (HRCT) scanning'''
-</small></small>
-<small><small>
 {|
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
@@ Line 170: / Line 173: @@
 !Weight loss
 !Associated Features
 |- style="background: #DCDCDC; padding: 5px;" |
 |
@@ Line 215: / Line 212: @@
 *CCTA combined with MPI
 |- style="background: #DCDCDC; padding: 5px;" |
-! rowspan="11" |Cardiac
+! rowspan="10" |Cardiac
 |- style="background: #DCDCDC; padding: 5px;" |
@@ Line 579: / Line 576: @@
 !Associated Features
 |- style="background: #DCDCDC; padding: 5px;" |
-! rowspan="12" |Pulmonary
+! rowspan="5" |Pulmonary
 !'''[[Pulmonary Embolism]]'''<ref name="pmid17904458">{{cite journal |vauthors=Stein PD, Beemath A, Matta F, Weg JG, Yusen RD, Hales CA, Hull RD, Leeper KV, Sostman HD, Tapson VF, Buckley JD, Gottschalk A, Goodman LR, Wakefied TW, Woodard PK |title=Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II |journal=Am. J. Med. |volume=120 |issue=10 |pages=871–9 |date=October 2007 |pmid=17904458 |pmc=2071924 |doi=10.1016/j.amjmed.2007.03.024 |url=}}</ref><ref name="pmid2332918">{{cite journal |vauthors= |title=Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED) |journal=JAMA |volume=263 |issue=20 |pages=2753–9 |date=1990 |pmid=2332918 |doi= |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px;" |[[Acute]]
@@ Line 698: / Line 695: @@
 | style="background: #F5F5F5; padding: 5px;" |
 *[[CT scan]]
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Pneumonia]]<ref name="pmid14683661">{{cite journal |vauthors=File TM |title=Community-acquired pneumonia |journal=Lancet |volume=362 |issue=9400 |pages=1991–2001 |date=December 2003 |pmid=14683661 |doi=10.1016/S0140-6736(03)15021-0 |url=}}</ref><ref name="pmid17278083">{{cite journal |vauthors=Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG |title=Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults |journal=Clin. Infect. Dis. |volume=44 Suppl 2 |issue= |pages=S27–72 |date=March 2007 |pmid=17278083 |doi=10.1086/511159 |url=}}</ref><ref name="pmid25337751">{{cite journal |vauthors=Musher DM, Thorner AR |title=Community-acquired pneumonia |journal=N. Engl. J. Med. |volume=371 |issue=17 |pages=1619–28 |date=October 2014 |pmid=25337751 |doi=10.1056/NEJMra1312885 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Acute]] or [[chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |
-*Dull
-*Localized to side of lesion
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Altered mental status]]
-*[[Tachycardia]]
-*Rust-colored [[sputum]]
-*Green [[sputum]]
-*Red currant-jelly [[sputum]]
-*[[Central cyanosis]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Long hospital stay
-* Ill contact exposure
-* [[Aspiration]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Wheezing]]
-*[[Rhonchi]]
-*[[Rales]]
-*[[Decreased breath sounds]]
-*[[Pleural friction rub]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Arterial blood gases|Arterial blood gas]] : [[Hypoxia]], [[hypoxemia]]
-*↑ [[Procalcitonin]]
-*[[Leukocytosis]]
-*[[Sputum culture|Sputum evaluation]]
-*Positive blood cultures
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Sinus tachycardia]]
-*Nonspecific [[ST-segment]] or T-wave changes
-| style="background: #F5F5F5; padding: 5px;" |
-*[[CXR]]: [[Interstitial infiltrates]], [[lobar]] consolidation, [[cavitation]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[CXR]]
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Tracheitis]]/ [[Bronchitis]]<ref name="pmid8327305">{{cite journal |vauthors=Conley SF, Beste DJ, Hoffmann RG |title=Measles-associated bacterial tracheitis |journal=Pediatr. Infect. Dis. J. |volume=12 |issue=5 |pages=414–5 |date=May 1993 |pmid=8327305 |doi= |url=}}</ref><ref name="pmid15577783">{{cite journal |vauthors=Salamone FN, Bobbitt DB, Myer CM, Rutter MJ, Greinwald JH |title=Bacterial tracheitis reexamined: is there a less severe manifestation? |journal=Otolaryngol Head Neck Surg |volume=131 |issue=6 |pages=871–6 |date=December 2004 |pmid=15577783 |doi=10.1016/j.otohns.2004.06.708 |url=}}</ref><ref name="pmid17015531">{{cite journal |vauthors=Hopkins A, Lahiri T, Salerno R, Heath B |title=Changing epidemiology of life-threatening upper airway infections: the reemergence of bacterial tracheitis |journal=Pediatrics |volume=118 |issue=4 |pages=1418–21 |date=October 2006 |pmid=17015531 |doi=10.1542/peds.2006-0692 |url=}}</ref><ref name="pmid6869336">{{cite journal |vauthors=Liston SL, Gehrz RC, Siegel LG, Tilelli J |title=Bacterial tracheitis |journal=Am. J. Dis. Child. |volume=137 |issue=8 |pages=764–7 |date=August 1983 |pmid=6869336 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Acute]]
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |
-*Dull
-*[[Substernal]]
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Tachypnea]]
-*[[Respiratory distress]]
-*[[Hoarseness]]
-*[[Dyspnea]]
-*[[Cyanosis]]
-*[[Sore throat]]
-*[[Odynophagia]]
-*[[Dysphonia]]
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Aspiration]]
-* [[Pneumonia]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Inspiratory [[stridor]] (with or without expiratory [[Stridor|stridor)]]
-*Nasal flaring
-*[[Wheezing]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Gram stain]] of [[exudates]]: [[Neutrophils]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Peaked P-wave
-| style="background: #F5F5F5; padding: 5px;" |
-*Radiography of the neck: [[Steeple sign]]
-*[[Laryngotracheobronchoscopy]]: a normal [[epiglottis]] with [[subglottic]] narrowing, thick and purulent secretions in the [[trachea]], [[pseudomembranes]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Endoscopy]]
-|- style="background: #DCDCDC; padding: 5px;" |
-!'''[[Pleuritis]]'''
-| style="background: #F5F5F5; padding: 5px;" |[[Acute]] or [[subacute]] or [[chronic]]
-| style="background: #F5F5F5; padding: 5px;" |May last minutes to hours
-| style="background: #F5F5F5; padding: 5px;" |
-*Sharp
-*Localized [[pleuritic]]
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*Sharp [[chest pain]] with breathing
-*[[Itching]] in sites on the back
-*[[Dizziness]]
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Autoimmune]] conditions
-* Infections
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Tachypnea]]
-* [[Tachycardia]]
-*[[Pleural friction rub|Pleural Rubs]]
-*Decreased breath sounds
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Leukocytosis]]
-*[[Arterial blood gases|Arterial blood gas (ABG)]]: [[Hypoxia]]
-*[[Thoracentesis|Thoracocentesis]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[EKG]] done to rule out other causes in differential diagnoses
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Chest X Ray]]: [[Pleural fluid]] on one or both sides
-*[[Computerized tomography]] (CT) scan: [[Pleural effusions]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[CXR]]
-|- style="background: #DCDCDC; padding: 5px;" |
-!'''[[Pulmonary Hypertension]]'''<ref name="pmid15006585">{{cite journal |vauthors=Mesquita SM, Castro CR, Ikari NM, Oliveira SA, Lopes AA |title=Likelihood of left main coronary artery compression based on pulmonary trunk diameter in patients with pulmonary hypertension |journal=Am. J. Med. |volume=116 |issue=6 |pages=369–74 |date=March 2004 |pmid=15006585 |doi=10.1016/j.amjmed.2003.11.015 |url=}}</ref><ref name="pmid11591592">{{cite journal |vauthors=Rich S, McLaughlin VV, O'Neill W |title=Stenting to reverse left ventricular ischemia due to left main coronary artery compression in primary pulmonary hypertension |journal=Chest |volume=120 |issue=4 |pages=1412–5 |date=October 2001 |pmid=11591592 |doi= |url=}}</ref><ref name="pmid10190427">{{cite journal |vauthors=Kawut SM, Silvestry FE, Ferrari VA, DeNofrio D, Axel L, Loh E, Palevsky HI |title=Extrinsic compression of the left main coronary artery by the pulmonary artery in patients with long-standing pulmonary hypertension |journal=Am. J. Cardiol. |volume=83 |issue=6 |pages=984–6, A10 |date=March 1999 |pmid=10190427 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Acute]] or [[subacute]] or [[chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Substernal]] pressure like
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Dyspnea]]
-*Symptoms of [[right heart failure]] ([[edema]])
-*Past history of [[heart murmur]]
-*[[Deep venous thrombosis|Deep venous thrombosis (DVT)]]
-*[[Arthritis]] or [[Arthralgia|arthralgias]]
-*[[Rash]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Smoking
-* [[HF]]
-* Heavy [[snoring]]
-* [[Morbid obesity]]
-| style="background: #F5F5F5; padding: 5px;" |
-*The intensity of the [[P2|pulmonic component of the second heart sound (P2]]) may be increased and the [[P2]] may demonstrate fixed or paradoxical [[splitting]].
-*[[Systolic ejection murmur]]
-*A [[S4|right-sided fourth heart sound (S4)]] with a left [[parasternal heave]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Abnormal [[Arterial blood gases|Arterial blood gas]]
-*[[Antinuclear antibody|Antinuclear antibody (ANA) levels]]
-*[[Anti-neutrophil cytoplasmic antibody|Antineutrophil cytoplasmic antibody (ANCA)]]
-*[[Brain natriuretic peptide|Brain natriuretic peptide (BNP of NT-proBNP)]]
-*[[HIV testing]]
-*[[Iron deficiency]]
-*[[PFTs|Pulmonary Function Testing]]
-*[[Polysomnography]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Right axis deviation]]
-*An R wave/S wave ratio greater than one in lead V1
-*Incomplete or complete [[right bundle branch block]]
-*Increased P wave amplitude in lead II (P pulmonale) due to right [[atrial enlargement]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Chest Radiography]]: [[Oligemic]] lung fields
-*[[Echocardiography]]:  [[PASP]] is >50 and the TRV is >3.4
-*[[Ventilation-Perfusion (V/Q) Lung Scanning]]: Abnormal
-*Right-sided [[cardiac catheterization]]: Mean [[PCWP]] >15 mmHg,
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Cardiac catheterization]]
 |- style="background: #DCDCDC; padding: 5px;" |
 ![[Pleural Effusion]]<ref name="pmid3757561">{{cite journal |vauthors=Feinsilver SH, Barrows AA, Braman SS |title=Fiberoptic bronchoscopy and pleural effusion of unknown origin |journal=Chest |volume=90 |issue=4 |pages=516–9 |date=October 1986 |pmid=3757561 |doi= |url=}}</ref><ref name="pmid3581930">{{cite journal |vauthors=Collins TR, Sahn SA |title=Thoracocentesis. Clinical value, complications, technical problems, and patient experience |journal=Chest |volume=91 |issue=6 |pages=817–22 |date=June 1987 |pmid=3581930 |doi= |url=}}</ref><ref name="pmid15753638">{{cite journal |vauthors=Venekamp LN, Velkeniers B, Noppen M |title=Does 'idiopathic pleuritis' exist? Natural history of non-specific pleuritis diagnosed after thoracoscopy |journal=Respiration |volume=72 |issue=1 |pages=74–8 |date=2005 |pmid=15753638 |doi=10.1159/000083404 |url=}}</ref>
@@ Line 894: / Line 733: @@
 | style="background: #F5F5F5; padding: 5px;" |
 *[[Computed tomography]]
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Asthma]] & [[COPD]]<ref name="pmid19423717">{{cite journal |vauthors=Kuempel ED, Wheeler MW, Smith RJ, Vallyathan V, Green FH |title=Contributions of dust exposure and cigarette smoking to emphysema severity in coal miners in the United States |journal=Am. J. Respir. Crit. Care Med. |volume=180 |issue=3 |pages=257–64 |date=August 2009 |pmid=19423717 |doi=10.1164/rccm.200806-840OC |url=}}</ref><ref name="pmid20884729">{{cite journal |vauthors=Lamprecht B, McBurnie MA, Vollmer WM, Gudmundsson G, Welte T, Nizankowska-Mogilnicka E, Studnicka M, Bateman E, Anto JM, Burney P, Mannino DM, Buist SA |title=COPD in never smokers: results from the population-based burden of obstructive lung disease study |journal=Chest |volume=139 |issue=4 |pages=752–763 |date=April 2011 |pmid=20884729 |pmc=3168866 |doi=10.1378/chest.10-1253 |url=}}</ref><ref name="pmid12412667">{{cite journal |vauthors=Rennard S, Decramer M, Calverley PM, Pride NB, Soriano JB, Vermeire PA, Vestbo J |title=Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey |journal=Eur. Respir. J. |volume=20 |issue=4 |pages=799–805 |date=October 2002 |pmid=12412667 |doi= |url=}}</ref><ref name="pmid8430714">{{cite journal |vauthors=Badgett RG, Tanaka DJ, Hunt DK, Jelley MJ, Feinberg LE, Steiner JF, Petty TL |title=Can moderate chronic obstructive pulmonary disease be diagnosed by historical and physical findings alone? |journal=Am. J. Med. |volume=94 |issue=2 |pages=188–96 |date=February 1993 |pmid=8430714 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Acute]] or [[subacute]] or [[chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |
-*Tightness
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Cyanosis]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Smoking
-* [[HF]]
-* [[HTN]]
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Elevated jugular venous pressure|Elevated jugular venous pulse (JVP]])
-* [[Hyperinflation]] ([[barrel chest]])
-* [[Peripheral edema]]
-* [[Clubbing]]
-*[[Wheezing]]
-*[[Rhonchi]]
-*Diffusely decreased [[breath sounds]]
-*Coarse [[crackles]] beginning with [[inspiration]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Leukocytosis]]
-*[[Eosinophilia]]
-*[[Respiratory alkalosis]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Peaked P-wave
-*Reduced amplitude of the [[QRS complexes]]
-*[[Multifocal atrial tachycardia]] (MAT)
-| style="background: #F5F5F5; padding: 5px;" |
-*[[CXR]]: [[Hyperinflation]]
-*[[Spirometry]]: ↓ [[FEV1]], [[Peak expiratory flow|PEF]], ↓ [[FEV1]]/[[FVC]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Spirometry]]
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Lung Cancer|Pulmonary Malignancy]]<ref name="pmid25564398">{{cite journal |vauthors=Kocher F, Hilbe W, Seeber A, Pircher A, Schmid T, Greil R, Auberger J, Nevinny-Stickel M, Sterlacci W, Tzankov A, Jamnig H, Kohler K, Zabernigg A, Frötscher J, Oberaigner W, Fiegl M |title=Longitudinal analysis of 2293 NSCLC patients: a comprehensive study from the TYROL registry |journal=Lung Cancer |volume=87 |issue=2 |pages=193–200 |date=February 2015 |pmid=25564398 |doi=10.1016/j.lungcan.2014.12.006 |url=}}</ref><ref name="pmid4813837">{{cite journal |vauthors=Hyde L, Hyde CI |title=Clinical manifestations of lung cancer |journal=Chest |volume=65 |issue=3 |pages=299–306 |date=March 1974 |pmid=4813837 |doi= |url=}}</ref><ref name="pmid2992757">{{cite journal |vauthors=Chute CG, Greenberg ER, Baron J, Korson R, Baker J, Yates J |title=Presenting conditions of 1539 population-based lung cancer patients by cell type and stage in New Hampshire and Vermont |journal=Cancer |volume=56 |issue=8 |pages=2107–11 |date=October 1985 |pmid=2992757 |doi= |url=}}</ref><ref name="pmid15165088">{{cite journal |vauthors=Hiraki A, Ueoka H, Takata I, Gemba K, Bessho A, Segawa Y, Kiura K, Eguchi K, Yoneda T, Tanimoto M, Harada M |title=Hypercalcemia-leukocytosis syndrome associated with lung cancer |journal=Lung Cancer |volume=43 |issue=3 |pages=301–7 |date=March 2004 |pmid=15165088 |doi=10.1016/j.lungcan.2003.09.006 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |Chronic
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |
-*Dull aching
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Bone pain]]
-*[[Fatigue]]
-*[[Neurologic dysfunction]]
-*[[Superior vena cava syndrome|Superior vena cava (SVC) obstruction]]
-*[[Hoarseness]]
-*Hemidiaphragm [[paralysis]]
-*[[Dysphagia]]
-*[[Paraneoplastic syndrome|Paraneoplastic syndromes]]
-*[[Hypercalcemia]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Smoking
-* [[Metastasis]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Wheeze]]
-*[[Crackles]]
-*Depending upon [[complications]] caused by the spread of [[cancer]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Hypercalcemia]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[EKG]] may be performed before cancer treatment to identify any pre-existing conditions, or during treatment to check for possible heart damage
-| style="background: #F5F5F5; padding: 5px;" |
-*[[CXR]] and [[CT scan]]: Mass lesion, [[hilar lymphadenopathy]]
-*[[Spirometry]]: ↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
-*[[Bronchoscopy]]: [[Biopsy]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Bronchoscopy]]
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Sarcoidosis]]<ref name="pmid26727158">{{cite journal |vauthors=Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL |title=Epidemiology of Sarcoidosis 1946-2013: A Population-Based Study |journal=Mayo Clin. Proc. |volume=91 |issue=2 |pages=183–8 |date=February 2016 |pmid=26727158 |pmc=4744129 |doi=10.1016/j.mayocp.2015.10.024 |url=}}</ref><ref name="pmid11734441">{{cite journal |vauthors=Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H, Bresnitz EA, DePalo L, Hunninghake G, Iannuzzi MC, Johns CJ, McLennan G, Moller DR, Newman LS, Rabin DL, Rose C, Rybicki B, Weinberger SE, Terrin ML, Knatterud GL, Cherniak R |title=Clinical characteristics of patients in a case control study of sarcoidosis |journal=Am. J. Respir. Crit. Care Med. |volume=164 |issue=10 Pt 1 |pages=1885–9 |date=November 2001 |pmid=11734441 |doi=10.1164/ajrccm.164.10.2104046 |url=}}</ref><ref name="pmid15753626">{{cite journal |vauthors=Rizzato G, Tinelli C |title=Unusual presentation of sarcoidosis |journal=Respiration |volume=72 |issue=1 |pages=3–6 |date=2005 |pmid=15753626 |doi=10.1159/000083392 |url=}}</ref><ref name="pmid15281433">{{cite journal |vauthors=Rizzato G, Palmieri G, Agrati AM, Zanussi C |title=The organ-specific extrapulmonary presentation of sarcoidosis: a frequent occurrence but a challenge to an early diagnosis. A 3-year-long prospective observational study |journal=Sarcoidosis Vasc Diffuse Lung Dis |volume=21 |issue=2 |pages=119–26 |date=June 2004 |pmid=15281433 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |Chronic
-| style="background: #F5F5F5; padding: 5px;" |Days to week
-| style="background: #F5F5F5; padding: 5px;" |
-*Chest fullness
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Löfgren syndrome]] ([[fever]], bilateral hilar [[lymphadenopathy]] (BHL), and [[Polyarthralgia|polyarthralgias]])
-*[[Uveitis]]
-*[[Heart block]]
-*[[Lymphocytic]] [[meningitis]]
-*[[Diabetes insipidus]]
-*[[Fatigue]]
-*[[Hypercalciuria]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Black population
-* [[Autoimmune]] diseases
-| style="background: #F5F5F5; padding: 5px;" |
-*Diminished respiratory sounds
-| style="background: #F5F5F5; padding: 5px;" |
-*↑ [[ACE level]], [[adenosine deaminase]], SAA, sIL2R
-*[[Hypercalciuria]]
-*Elevated [[1,25-dihydroxyvitamin D]] levels
-| style="background: #F5F5F5; padding: 5px;" |
-*[[AV block]]
-*Prolongation of the [[PR interval]] (first-degree AV block)
-*[[Ventricular arrhythmias]] (sustained or nonsustained [[ventricular tachycardia]] and ventricular premature beats [VPBs])
-*[[Supraventricular arrhythmias]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Chest radiograph]]: [[Bilateral hilar adenopathy]]
-*High-resolution CT (HRCT) scanning of the chest: [[Ground glass]] opacification, Hilar and [[mediastinal lymphadenopathy]],    [[Bronchial]] wall thickening
-| style="background: #F5F5F5; padding: 5px;" |
-*Lung [[Biopsy]]
 |- style="background: #DCDCDC; padding: 5px;" |
 ![[Acute chest syndrome]] ([[Sickle cell anemia|Sickle cell anemia)]]<ref name="pmid9057664">{{cite journal |vauthors=Vichinsky EP, Styles LA, Colangelo LH, Wright EC, Castro O, Nickerson B |title=Acute chest syndrome in sickle cell disease: clinical presentation and course. Cooperative Study of Sickle Cell Disease |journal=Blood |volume=89 |issue=5 |pages=1787–92 |date=March 1997 |pmid=9057664 |doi= |url=}}</ref><ref name="pmid7517723">{{cite journal |vauthors=Castro O, Brambilla DJ, Thorington B, Reindorf CA, Scott RB, Gillette P, Vera JC, Levy PS |title=The acute chest syndrome in sickle cell disease: incidence and risk factors. The Cooperative Study of Sickle Cell Disease |journal=Blood |volume=84 |issue=2 |pages=643–9 |date=July 1994 |pmid=7517723 |doi= |url=}}</ref><ref name="pmid10861320">{{cite journal |vauthors=Vichinsky EP, Neumayr LD, Earles AN, Williams R, Lennette ET, Dean D, Nickerson B, Orringer E, McKie V, Bellevue R, Daeschner C, Manci EA |title=Causes and outcomes of the acute chest syndrome in sickle cell disease. National Acute Chest Syndrome Study Group |journal=N. Engl. J. Med. |volume=342 |issue=25 |pages=1855–65 |date=June 2000 |pmid=10861320 |doi=10.1056/NEJM200006223422502 |url=}}</ref>
@@ Line 1,061: / Line 788: @@
 |- style="background: #DCDCDC; padding: 5px;" |
 | rowspan="9" |Gastrointestinal
-!'''[[GERD]], [[Peptic Ulcer]]'''<ref name="pmid16928254">{{cite journal |vauthors=Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R |title=The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus |journal=Am. J. Gastroenterol. |volume=101 |issue=8 |pages=1900–20; quiz 1943 |date=August 2006 |pmid=16928254 |doi=10.1111/j.1572-0241.2006.00630.x |url=}}</ref><ref name="pmid15290658">{{cite journal |vauthors=Vakil NB, Traxler B, Levine D |title=Dysphagia in patients with erosive esophagitis: prevalence, severity, and response to proton pump inhibitor treatment |journal=Clin. Gastroenterol. Hepatol. |volume=2 |issue=8 |pages=665–8 |date=August 2004 |pmid=15290658 |doi= |url=}}</ref><ref name="pmid18289194">{{cite journal |vauthors=Giannini EG, Zentilin P, Dulbecco P, Vigneri S, Scarlata P, Savarino V |title=Management strategy for patients with gastroesophageal reflux disease: a comparison between empirical treatment with esomeprazole and endoscopy-oriented treatment |journal=Am. J. Gastroenterol. |volume=103 |issue=2 |pages=267–75 |date=February 2008 |pmid=18289194 |doi=10.1111/j.1572-0241.2007.01659.x |url=}}</ref>
+!'''Perforated [[Peptic Ulcer]]'''<ref name="pmid16928254">{{cite journal |vauthors=Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R |title=The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus |journal=Am. J. Gastroenterol. |volume=101 |issue=8 |pages=1900–20; quiz 1943 |date=August 2006 |pmid=16928254 |doi=10.1111/j.1572-0241.2006.00630.x |url=}}</ref><ref name="pmid15290658">{{cite journal |vauthors=Vakil NB, Traxler B, Levine D |title=Dysphagia in patients with erosive esophagitis: prevalence, severity, and response to proton pump inhibitor treatment |journal=Clin. Gastroenterol. Hepatol. |volume=2 |issue=8 |pages=665–8 |date=August 2004 |pmid=15290658 |doi= |url=}}</ref><ref name="pmid18289194">{{cite journal |vauthors=Giannini EG, Zentilin P, Dulbecco P, Vigneri S, Scarlata P, Savarino V |title=Management strategy for patients with gastroesophageal reflux disease: a comparison between empirical treatment with esomeprazole and endoscopy-oriented treatment |journal=Am. J. Gastroenterol. |volume=103 |issue=2 |pages=267–75 |date=February 2008 |pmid=18289194 |doi=10.1111/j.1572-0241.2007.01659.x |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px;" |[[Acute (medicine)|Acute]]
 | style="background: #F5F5F5; padding: 5px;" |
@@ Line 1,100: / Line 827: @@
 | style="background: #F5F5F5; padding: 5px;" |
 *Upper [[Gastrointestinal]] [[Endoscopy]]
-|- style="background: #DCDCDC; padding: 5px;" |
-!'''[[Diffuse Esophageal Spasm]]'''<ref name="pmid3826958">{{cite journal |vauthors=Katz PO, Dalton CB, Richter JE, Wu WC, Castell DO |title=Esophageal testing of patients with noncardiac chest pain or dysphagia. Results of three years' experience with 1161 patients |journal=Ann. Intern. Med. |volume=106 |issue=4 |pages=593–7 |date=April 1987 |pmid=3826958 |doi= |url=}}</ref><ref name="pmid20179690">{{cite journal |vauthors=Kahrilas PJ |title=Esophageal motor disorders in terms of high-resolution esophageal pressure topography: what has changed? |journal=Am. J. Gastroenterol. |volume=105 |issue=5 |pages=981–7 |date=May 2010 |pmid=20179690 |pmc=2888528 |doi=10.1038/ajg.2010.43 |url=}}</ref><ref name="pmid17900331">{{cite journal |vauthors=Pandolfino JE, Ghosh SK, Rice J, Clarke JO, Kwiatek MA, Kahrilas PJ |title=Classifying esophageal motility by pressure topography characteristics: a study of 400 patients and 75 controls |journal=Am. J. Gastroenterol. |volume=103 |issue=1 |pages=27–37 |date=January 2008 |pmid=17900331 |doi=10.1111/j.1572-0241.2007.01532.x |url=}}</ref><ref name="pmid18364587">{{cite journal |vauthors=Kahrilas PJ, Ghosh SK, Pandolfino JE |title=Esophageal motility disorders in terms of pressure topography: the Chicago Classification |journal=J. Clin. Gastroenterol. |volume=42 |issue=5 |pages=627–35 |date=2008 |pmid=18364587 |pmc=2895002 |doi=10.1097/MCG.0b013e31815ea291 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Acute (medicine)|Acute]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Minutes to hours
-*5 to 60 minutes
-| style="background: #F5F5F5; padding: 5px;" |
-*Burning
-*Pressure
-*[[Visceral]], spontaneous, [[substernal]]
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
-*Associated with cold liquids
-*Relief with [[nitroglycerin]]
-| style="background: #F5F5F5; padding: 5px;" | ---
-| style="background: #F5F5F5; padding: 5px;" | ---
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Barium swallow]]: Multiple areas of [[spasm]]  throughout the length of the esophagus
-*Impedance testing: Higher amplitudes and better transit of swallowed boluses
-| style="background: #F5F5F5; padding: 5px;" |
-*No ECG findings associated with DES, but ECG is done to exclude [[variant angina]] due to higher concurrent association of variant angina with DES
-| style="background: #F5F5F5; padding: 5px;" |
-*Esophageal [[Esophageal motility study|manometry]] : ≥20 percent premature contractions (distal latency <4.5 seconds)
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Esophageal manometry]]
 |- style="background: #DCDCDC; padding: 5px;" |
 ![[Esophagitis]]<ref name="pmid3605035">{{cite journal |vauthors=Bott S, Prakash C, McCallum RW |title=Medication-induced esophageal injury: survey of the literature |journal=Am. J. Gastroenterol. |volume=82 |issue=8 |pages=758–63 |date=August 1987 |pmid=3605035 |doi= |url=}}</ref><ref name="pmid18763324">{{cite journal |vauthors=Parfitt JR, Jayakumar S, Driman DK |title=Mycophenolate mofetil-related gastrointestinal mucosal injury: variable injury patterns, including graft-versus-host disease-like changes |journal=Am. J. Surg. Pathol. |volume=32 |issue=9 |pages=1367–72 |date=September 2008 |pmid=18763324 |doi= |url=}}</ref><ref name="pmid10738847">{{cite journal |vauthors=Jaspersen D |title=Drug-induced oesophageal disorders: pathogenesis, incidence, prevention and management |journal=Drug Saf |volume=22 |issue=3 |pages=237–49 |date=March 2000 |pmid=10738847 |doi= |url=}}</ref>
@@ Line 1,159: / Line 858: @@
 | style="background: #F5F5F5; padding: 5px;" |
 *[[Endoscopy]]
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Eosinophilic esophagitis|Eosinophilic Esophagitis]]<ref name="pmid18471509">{{cite journal |vauthors=Kapel RC, Miller JK, Torres C, Aksoy S, Lash R, Katzka DA |title=Eosinophilic esophagitis: a prevalent disease in the United States that affects all age groups |journal=Gastroenterology |volume=134 |issue=5 |pages=1316–21 |date=May 2008 |pmid=18471509 |doi=10.1053/j.gastro.2008.02.016 |url=}}</ref><ref name="pmid12612531">{{cite journal |vauthors=Straumann A, Rossi L, Simon HU, Heer P, Spichtin HP, Beglinger C |title=Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis? |journal=Gastrointest. Endosc. |volume=57 |issue=3 |pages=407–12 |date=March 2003 |pmid=12612531 |doi=10.1067/mge.2003.123 |url=}}</ref><ref name="pmid18407800">{{cite journal |vauthors=Straumann A, Bussmann C, Zuber M, Vannini S, Simon HU, Schoepfer A |title=Eosinophilic esophagitis: analysis of food impaction and perforation in 251 adolescent and adult patients |journal=Clin. Gastroenterol. Hepatol. |volume=6 |issue=5 |pages=598–600 |date=May 2008 |pmid=18407800 |doi=10.1016/j.cgh.2008.02.003 |url=}}</ref><ref name="pmid19577011">{{cite journal |vauthors=Prasad GA, Alexander JA, Schleck CD, Zinsmeister AR, Smyrk TC, Elias RM, Locke GR, Talley NJ |title=Epidemiology of eosinophilic esophagitis over three decades in Olmsted County, Minnesota |journal=Clin. Gastroenterol. Hepatol. |volume=7 |issue=10 |pages=1055–61 |date=October 2009 |pmid=19577011 |pmc=3026355 |doi=10.1016/j.cgh.2009.06.023 |url=}}</ref><ref name="pmid17764492">{{cite journal |vauthors=Prasad GA, Talley NJ, Romero Y, Arora AS, Kryzer LA, Smyrk TC, Alexander JA |title=Prevalence and predictive factors of eosinophilic esophagitis in patients presenting with dysphagia: a prospective study |journal=Am. J. Gastroenterol. |volume=102 |issue=12 |pages=2627–32 |date=December 2007 |pmid=17764492 |doi=10.1111/j.1572-0241.2007.01512.x |url=}}</ref><ref name="pmid15933677">{{cite journal |vauthors=Desai TK, Stecevic V, Chang CH, Goldstein NS, Badizadegan K, Furuta GT |title=Association of eosinophilic inflammation with esophageal food impaction in adults |journal=Gastrointest. Endosc. |volume=61 |issue=7 |pages=795–801 |date=June 2005 |pmid=15933677 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Chronic (medical)|Chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |
-*Burning
-*[[Retrosternal]]
-*Abdominal
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Dysphagia]]
-* Food impaction
-* [[GERD]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Allergy|Allergic]] [[Disease|diseases]]
-*[[Asthma]]
-*[[Rinitis]]
-*[[Eczema]]
-| style="background: #F5F5F5; padding: 5px;" |
-*No auscultatory finding in the this [[disease]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Elevated [[IgE]] (>114,000 units/L)
-*Elevated peripheral [[eosinophils]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Typically no finding on EKG
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Barium studies]]: [[Strictures]] and a ringed esophagus
-*[[Endoscopy]]: Stacked circular rings ("feline" esophagus)  ●[[Strictures]]   ●Linear furrows   ●Whitish papules
-*[[Esophageal biopsy]]: More than 15 [[Eosinophil granulocyte|eosinophils]] per high-power field
-| style="background: #F5F5F5; padding: 5px;" |
-*Esophageal [[biopsy]]
 |- style="background: #DCDCDC; padding: 5px;" |
 ![[Esophageal perforation|Esophageal Perforation]]<ref name="pmid2730190">{{cite journal |vauthors=Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH |title=Spontaneous rupture of the esophagus: a 30-year experience |journal=Ann. Thorac. Surg. |volume=47 |issue=5 |pages=689–92 |date=May 1989 |pmid=2730190 |doi= |url=}}</ref>
@@ Line 1,262: / Line 927: @@
 | style="background: #F5F5F5; padding: 5px;" | CT scan
 |- style="background: #DCDCDC; padding: 5px;" |
-!'''[[Gallstone disease| Cholelithiasis]]'''<ref name="pmid19190960">{{cite journal |vauthors=Fitzgerald JE, White MJ, Lobo DN |title=Courvoisier's gallbladder: law or sign? |journal=World J Surg |volume=33 |issue=4 |pages=886–91 |date=April 2009 |pmid=19190960 |doi=10.1007/s00268-008-9908-y |url=}}</ref><ref name="pmid18000708">{{cite journal |vauthors=Yang MH, Chen TH, Wang SE, Tsai YF, Su CH, Wu CW, Lui WY, Shyr YM |title=Biochemical predictors for absence of common bile duct stones in patients undergoing laparoscopic cholecystectomy |journal=Surg Endosc |volume=22 |issue=7 |pages=1620–4 |date=July 2008 |pmid=18000708 |doi=10.1007/s00464-007-9665-2 |url=}}</ref><ref name="pmid10077048">{{cite journal |vauthors=Prat F, Meduri B, Ducot B, Chiche R, Salimbeni-Bartolini R, Pelletier G |title=Prediction of common bile duct stones by noninvasive tests |journal=Ann. Surg. |volume=229 |issue=3 |pages=362–8 |date=March 1999 |pmid=10077048 |pmc=1191701 |doi= |url=}}</ref><ref name="pmid15332044">{{cite journal |vauthors=Tse F, Barkun JS, Barkun AN |title=The elective evaluation of patients with suspected choledocholithiasis undergoing laparoscopic cholecystectomy |journal=Gastrointest. Endosc. |volume=60 |issue=3 |pages=437–48 |date=September 2004 |pmid=15332044 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Acute (medicine)|Acute]], [[subacute]]
-| style="background: #F5F5F5; padding: 5px;" |Minutes to hours
-| style="background: #F5F5F5; padding: 5px;" |
-*Burning
-*Colicky
-*Right upper [[abdomen]]
-*Substernal
-*[[epigastric]]
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Obesity]]
-*Fertile females in 40's
-| style="background: #F5F5F5; padding: 5px;" |
-*The presence of a common bile duct stone on transabdominal ultrasound
-•Clinical acute cholangitis
-•A serum bilirubin greater than 4 mg/dL (68 micromol/L)
-| style="background: #F5F5F5; padding: 5px;" |
-*Murphy sign negative
-*Jaundice
-| style="background: #F5F5F5; padding: 5px;" |
-*↑ALT
-*↑AST
-*↑[[Amylase]] levels
-*↑ALP
-| style="background: #F5F5F5; padding: 5px;" |
-*Typically not indicated
-| style="background: #F5F5F5; padding: 5px;" |
-*Transabdominal [[ultrasound]] (TAUS): shows gallstones
-*EUS: Detects biliary sludge
-*MRCP: Detects stones >6mm
-*Endoscopic Retrograde Cholangiopancreatography (ERCP): Diagnostic and therapeutic removal of stones
-|Endoscopic ultrasound and MECP
-|- style="background: #DCDCDC; padding: 5px;" |
 ![[Pancreatitis]]<ref name="pmid6237447">{{cite journal |vauthors=Dickson AP, Imrie CW |title=The incidence and prognosis of body wall ecchymosis in acute pancreatitis |journal=Surg Gynecol Obstet |volume=159 |issue=4 |pages=343–7 |date=October 1984 |pmid=6237447 |doi= |url=}}</ref><ref name="pmid12094843">{{cite journal |vauthors=Yadav D, Agarwal N, Pitchumoni CS |title=A critical evaluation of laboratory tests in acute pancreatitis |journal=Am. J. Gastroenterol. |volume=97 |issue=6 |pages=1309–18 |date=June 2002 |pmid=12094843 |doi=10.1111/j.1572-0241.2002.05766.x |url=}}</ref><ref name="pmid8540502">{{cite journal |vauthors=Fortson MR, Freedman SN, Webster PD |title=Clinical assessment of hyperlipidemic pancreatitis |journal=Am. J. Gastroenterol. |volume=90 |issue=12 |pages=2134–9 |date=December 1995 |pmid=8540502 |doi= |url=}}</ref><ref name="pmid10352598">{{cite journal |vauthors=Lecesne R, Taourel P, Bret PM, Atri M, Reinhold C |title=Acute pancreatitis: interobserver agreement and correlation of CT and MR cholangiopancreatography with outcome |journal=Radiology |volume=211 |issue=3 |pages=727–35 |date=June 1999 |pmid=10352598 |doi=10.1148/radiology.211.3.r99jn08727 |url=}}</ref><ref name="pmid17378903">{{cite journal |vauthors=Stimac D, Miletić D, Radić M, Krznarić I, Mazur-Grbac M, Perković D, Milić S, Golubović V |title=The role of nonenhanced magnetic resonance imaging in the early assessment of acute pancreatitis |journal=Am. J. Gastroenterol. |volume=102 |issue=5 |pages=997–1004 |date=May 2007 |pmid=17378903 |doi=10.1111/j.1572-0241.2007.01164.x |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px;" |[[Acute (medicine)|Acute]], [[Chronic (medical)|Chronic]]
@@ Line 1,342: / Line 971: @@
 *CT Scan
 |- style="background: #DCDCDC; padding: 5px;" |
-![[Hiatal Hernia|Sliding Hiatal Hernia]]<ref name="pmid8899401">{{cite journal |vauthors=Weston AP |title=Hiatal hernia with cameron ulcers and erosions |journal=Gastrointest. Endosc. Clin. N. Am. |volume=6 |issue=4 |pages=671–9 |date=October 1996 |pmid=8899401 |doi= |url=}}</ref><ref name="pmid16472589">{{cite journal |vauthors=Bredenoord AJ, Weusten BL, Timmer R, Smout AJ |title=Intermittent spatial separation of diaphragm and lower esophageal sphincter favors acidic and weakly acidic reflux |journal=Gastroenterology |volume=130 |issue=2 |pages=334–40 |date=February 2006 |pmid=16472589 |doi=10.1053/j.gastro.2005.10.053 |url=}}</ref><ref name="pmid18656819">{{cite journal |vauthors=Kahrilas PJ, Kim HC, Pandolfino JE |title=Approaches to the diagnosis and grading of hiatal hernia |journal=Best Pract Res Clin Gastroenterol |volume=22 |issue=4 |pages=601–16 |date=2008 |pmid=18656819 |pmc=2548324 |doi=10.1016/j.bpg.2007.12.007 |url=}}</ref>
+![[IBD]]<ref name="ColbertSchmidt2017">{{cite journal|last1=Colbert|first1=James F.|last2=Schmidt|first2=Eric P.|last3=Faubel|first3=Sarah|last4=Ginde|first4=Adit A.|title=Severe Sepsis Outcomes Among Hospitalizations With Inflammatory Bowel Disease|journal=SHOCK|volume=47|issue=2|year=2017|pages=128–131|issn=1073-2322|doi=10.1097/SHK.0000000000000742}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Acute (medicine)|Acute]]
+| style="background: #F5F5F5; padding: 5px;" |[[Acute (medicine)|Acute]], [[Chronic (medical)|Chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Epigastric]]
-*Burning
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Obstruction]]
-*Cameron [[Ulcer|ulcers]]
-*GERD
-*Dysphagia
-| style="background: #F5F5F5; padding: 5px;" |
-* Trauma
-* Iatrogenic
-* Congenital malformation
-| style="background: #F5F5F5; padding: 5px;" |
-*Bowel sounds may be heard in the chest
-| style="background: #F5F5F5; padding: 5px;" |
-*Non specific
-| style="background: #F5F5F5; padding: 5px;" |
-*T wave inversion in anterior lead.
-| style="background: #F5F5F5; padding: 5px;" |
-*Barium swallow: At least three rugal folds traversing the diaphragm
-*Upper endoscopy: A greater than 2-cm separation between the squamocolumnar junction and the diaphragmatic impression
-*High resolution manometry: The separation of the crural diaphragm from the lower esophageal sphincter (LES) by a pressure trough
-| style="background: #F5F5F5; padding: 5px;" |
-*Upper endoscopy
-*High resolution manometry (for smaller hernias)
-|- style="background: #DCDCDC; padding: 5px;" |
-| rowspan="6" |Musculoskeletal
-![[Costochondritis|Costosternal syndromes (costochondritis)]]<ref name="pmid1247350">{{cite journal |vauthors=Wolf E, Stern S |title=Costosternal syndrome: its frequency and importance in differential diagnosis of coronary heart disease |journal=Arch. Intern. Med. |volume=136 |issue=2 |pages=189–91 |date=February 1976 |pmid=1247350 |doi= |url=}}</ref><ref name="pmid4027804">{{cite journal |vauthors=Fam AG, Smythe HA |title=Musculoskeletal chest wall pain |journal=CMAJ |volume=133 |issue=5 |pages=379–89 |date=September 1985 |pmid=4027804 |pmc=1346531 |doi= |url=}}</ref><ref name="pmid20406787">{{cite journal |vauthors=Bösner S, Becker A, Hani MA, Keller H, Sönnichsen AC, Karatolios K, Schaefer JR, Haasenritter J, Baum E, Donner-Banzhoff N |title=Chest wall syndrome in primary care patients with chest pain: presentation, associated features and diagnosis |journal=Fam Pract |volume=27 |issue=4 |pages=363–9 |date=August 2010 |pmid=20406787 |doi=10.1093/fampra/cmq024 |url=}}</ref><ref name="pmid28593100">{{cite journal |vauthors=Zaruba RA, Wilson E |title=IMPAIRMENT BASED EXAMINATION AND TREATMENT OF COSTOCHONDRITIS: A CASE SERIES |journal=Int J Sports Phys Ther |volume=12 |issue=3 |pages=458–467 |date=June 2017 |pmid=28593100 |pmc=5455195 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |Acute, subacute
-| style="background: #F5F5F5; padding: 5px;" |Days to weeks
-| style="background: #F5F5F5; padding: 5px;" |
-*Pressure like on anterior part of chest wall
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*History of repeated minor trauma or unaccustomed activity (eg, painting, moving furniture)
-| style="background: #F5F5F5; padding: 5px;" |
-* Trauma
-| style="background: #F5F5F5; padding: 5px;" |
-*Pain by palpation of tender areas
-*Maneuvers, such as the "crowing rooster" and horizontal arm flexion maneuver
-| style="background: #F5F5F5; padding: 5px;" |
-*Non specific
-| style="background: #F5F5F5; padding: 5px;" |
-*EKG is done to rule out other cardiovascular causes
-| style="background: #F5F5F5; padding: 5px;" |
-*CXR: To rule out fracture
-|Pain by palpation of tender areas
-|- style="background: #DCDCDC; padding: 5px;" |
-!Lower rib pain syndromes<ref name="pmid8344569">{{cite journal |vauthors=Scott EM, Scott BB |title=Painful rib syndrome--a review of 76 cases |journal=Gut |volume=34 |issue=7 |pages=1006–8 |date=July 1993 |pmid=8344569 |pmc=1374244 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |Chronic
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |
-*Aching
-*Lower chest
-*Upper abdomen
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*Common in women with a mean age in the mid-40s
-| style="background: #F5F5F5; padding: 5px;" | ---
-| style="background: #F5F5F5; padding: 5px;" |
-*Hooking maneuver
-*Reproduces pain by pressing a tender spot on the costal margin
-| style="background: #F5F5F5; padding: 5px;" |
-*Non specific
-*The workup is done for excluding cardiac disorders and other causes of chest pain
-| style="background: #F5F5F5; padding: 5px;" |
-*EKG is done to rule out other cardiovascular causes
-| style="background: #F5F5F5; padding: 5px;" |
-*CXR: To rule out fracture
-| style="background: #F5F5F5; padding: 5px;" | ---
-|- style="background: #DCDCDC; padding: 5px;" |
-!Sternalis syndrome
-| style="background: #F5F5F5; padding: 5px;" |Chronic
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |Pressure like pain
-*Over the body of sternum
-*Sternalis muscle
-*Left or middle side of the chest wall
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Heart|Cardiac]] diseases
-| style="background: #F5F5F5; padding: 5px;" |
-* Daily activities
-* Emotional [[distress]]
-* [[Anxiety]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Localized [[tenderness]] is found directly over the body of the sternum or overlying sternalis muscle
-| style="background: #F5F5F5; padding: 5px;" |
-*No specific diagnostic test for this disease
-*The workup is done for excluding cardiac disorders and other causes of chest pain
-| style="background: #F5F5F5; padding: 5px;" |
-*EKG is done to rule out other cardiovascular causes
-| style="background: #F5F5F5; padding: 5px;" |
-*[[X-rays|X-ray]] : To rule out fracture
-| style="background: #F5F5F5; padding: 5px;" |
-*Physical exam
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Tietze's syndrome]]<ref name="pmid1697801">{{cite journal |vauthors=Aeschlimann A, Kahn MF |title=Tietze's syndrome: a critical review |journal=Clin. Exp. Rheumatol. |volume=8 |issue=4 |pages=407–12 |date=1990 |pmid=1697801 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |Acute
-| style="background: #F5F5F5; padding: 5px;" |Weeks
-| style="background: #F5F5F5; padding: 5px;" |Pressure like pain over
-*Costosternal joint
-*[[Sternoclavicular articulation|Sternoclavicular]] joint
-*[[Costochondral joint|Costochondral]] joint
-*Second and third ribs
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*Most often involve the areas of 2nd and 3rd ribs
-*More common in young adults
-*Sternocostoclavicular hyperostosis
-*Ankylosing spondylitis
-| style="background: #F5F5F5; padding: 5px;" |
-* Upper respiratory infections
-* Excessive coughing
-| style="background: #F5F5F5; padding: 5px;" |
-*Painful and localized swelling of the costosternal, [[Sternoclavicular articulation|sternoclavicular]], or [[Costochondral joint|costochondral joints]] most often involving 2nd and 3rd [[ribs]]
-| style="background: #F5F5F5; padding: 5px;" |
-*No specific diagnostic test for this disease
-*The workup is done for excluding cardiac disorders and other causes of chest pain
-| style="background: #F5F5F5; padding: 5px;" |
-*EKG is done to rule out other cardiovascular causes
-| style="background: #F5F5F5; padding: 5px;" |
-*[[X-rays|X-ray]]: To rule out fracture
-| style="background: #F5F5F5; padding: 5px;" |
-*Tests are done to rule out other diseases
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Xiphoidalgia]]<ref name="pmid13266001">{{cite journal |vauthors=LIPKIN M, FULTON LA, WOLFSON EA |title=The syndrome of the hypersensitive xiphoid |journal=N. Engl. J. Med. |volume=253 |issue=14 |pages=591–7 |date=October 1955 |pmid=13266001 |doi=10.1056/NEJM195510062531403 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |Acute
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |Pressure like pain over
-*Over the xiphoid process
-*Sternum
-*Xiphisternal joint
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*Symptoms are aggravated by twisting and bending movements
-| style="background: #F5F5F5; padding: 5px;" |
-* Cough
-* Heavy work
-| style="background: #F5F5F5; padding: 5px;" |
-*Provocative test
-| style="background: #F5F5F5; padding: 5px;" |
-*No specific diagnostic test for this disease
-*The workup is done for excluding cardiac disorders and other causes of chest pain
-| style="background: #F5F5F5; padding: 5px;" |
-*EKG is done to rule out other cardiovascular causes
-| style="background: #F5F5F5; padding: 5px;" |
-*X-ray: To rule out fracture
-| style="background: #F5F5F5; padding: 5px;" |
-*Tests are done to rule out other diseases
-|- style="background: #DCDCDC; padding: 5px;" |
-!Spontaneous [[sternoclavicular]] [[subluxation]]<ref name="pmid1458785">{{cite journal |vauthors=van Holsbeeck M, van Melkebeke J, Dequeker J, Pennes DR |title=Radiographic findings of spontaneous subluxation of the sternoclavicular joint |journal=Clin. Rheumatol. |volume=11 |issue=3 |pages=376–81 |date=September 1992 |pmid=1458785 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |Acute, Chronic
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |Aching pain over [[Sternoclavicular articulation|Sternoclavicular joint]]
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*More common in middle age [[women]]
-*Occurs in dominant hands with repetitive tasks of heavy or moderate quality
-| style="background: #F5F5F5; padding: 5px;" |
-* Trauma
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Palpation]] of tender areas
-| style="background: #F5F5F5; padding: 5px;" |
-*No specific diagnostic test for this disease
-*The workup is done for excluding cardiac disorders and other causes of chest pain
-| style="background: #F5F5F5; padding: 5px;" |
-*EKG is done to rule out other cardiovascular causes
-| style="background: #F5F5F5; padding: 5px;" |
-*[[X-rays|X-ray]]: Sclerosis of the medial clavicle
-| style="background: #F5F5F5; padding: 5px;" |
-*X-ray
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-! rowspan="3" |Differentials on the basis of Etiology
-! rowspan="3" |Disease
-! colspan="10" |Clinical manifestations
-! colspan="4" |Diagnosis
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-| colspan="8" |Symptoms
-| rowspan="2" |Risk factors
-! rowspan="2" |Physical exam
-! rowspan="2" |Lab workup
-! rowspan="2" |EKG
-! rowspan="2" |Imaging
-! rowspan="2" |Gold standard
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-!Onset
-!Duration
-!Quality of Pain
-!Cough
-!Fever
-!Dyspnea
-!Weight loss
-!Associated Features
-|- style="background: #DCDCDC; padding: 5px;" |
-| rowspan="7" |Rheumatic
-![[Fibromyalgia]]<ref name="pmid20380956">{{cite journal |vauthors=Almansa C, Wang B, Achem SR |title=Noncardiac chest pain and fibromyalgia |journal=Med. Clin. North Am. |volume=94 |issue=2 |pages=275–89 |date=March 2010 |pmid=20380956 |doi=10.1016/j.mcna.2010.01.002 |url=}}</ref><ref name="pmid7979843">{{cite journal |vauthors=Disla E, Rhim HR, Reddy A, Karten I, Taranta A |title=Costochondritis. A prospective analysis in an emergency department setting |journal=Arch. Intern. Med. |volume=154 |issue=21 |pages=2466–9 |date=November 1994 |pmid=7979843 |doi= |url=}}</ref><ref name="pmid1543409">{{cite journal |vauthors=Wise CM, Semble EL, Dalton CB |title=Musculoskeletal chest wall syndromes in patients with noncardiac chest pain: a study of 100 patients |journal=Arch Phys Med Rehabil |volume=73 |issue=2 |pages=147–9 |date=February 1992 |pmid=1543409 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Chronic (medical)|Chronic]]
 | style="background: #F5F5F5; padding: 5px;" |Variable
 | style="background: #F5F5F5; padding: 5px;" |
-*Raynaud phenomenon (RP)
+*Painful bowl movments
-*Deep [[Pain|ache]] and burning pain on
+*Bloody diarrhea
-**[[Shoulder|Shoulders]]
+*pus or mucus in the stool
-**Back of the [[Neck]]
+*Fistula
-**[[Chest]]
+*sepsis
-**Lower [[Human back|Back]]
+*pseudo  memberanous colitis
-**[[Elbow|Elbows]]
-**[[Hip (anatomy)|Hips]]
-**Shin
-**[[Knee|Knees]]
-| style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Somatization]]
-*[[Depression]]
-*IBS
-| style="background: #F5F5F5; padding: 5px;" | ---
-| style="background: #F5F5F5; padding: 5px;" |
-*Presence of [[tenderness]] in soft-tissue anatomic locations
-| style="background: #F5F5F5; padding: 5px;" |
-*Non specific
-*Normal [[Blood, Sweat & Tea|Blood]] and [[Urine|urine test]] (mandatory to rule out other diseases)
-| style="background: #F5F5F5; padding: 5px;" |
-*P-wave dispersions (Pd)
-| style="background: #F5F5F5; padding: 5px;" | ---
-| style="background: #F5F5F5; padding: 5px;" | ---
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Rheumatoid arthritis]]<ref name="pmid23335586">{{cite journal |vauthors=Rodríguez-Henríquez P, Solano C, Peña A, León-Hernández S, Hernández-Díaz C, Gutiérrez M, Pineda C |title=Sternoclavicular joint involvement in rheumatoid arthritis: clinical and ultrasound findings of a neglected joint |journal=Arthritis Care Res (Hoboken) |volume=65 |issue=7 |pages=1177–82 |date=July 2013 |pmid=23335586 |doi=10.1002/acr.21958 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Chronic (medical)|Chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Years
-| style="background: #F5F5F5; padding: 5px;" |Symmetrical joint pain in
-*Wrist
-*Fingers
-*[[Knee|Knees]]
-*Feet
-*Ankles
-| style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-*Extra-articular involvement of other organ systems
+*Gastric perforation
-*[[Carpal tunnel syndrome]]
+*Colon cancer
-*[[Tarsal tunnel syndrome]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Old age
+* Genetic predisposition
+* Alcohol abuse
 * Smoking
-* Autoimmune conditions
+* Microbiata and infections
 | style="background: #F5F5F5; padding: 5px;" |
-*Reduced grip strength
+*Hypotension
-*[[Rheumatoid nodules]]
+*Abdominal tenderness
 | style="background: #F5F5F5; padding: 5px;" |
-*Positive Rheumatic Factor
+*Electrolyte disturbance
-*Anti-CCP body
+*Leukocytosis
-*Synovial fluid analysis: WBC between 1500 and 25,000/cubicmm, low glucose, low C3 and C4 complement level.
-*Thrombocytosis
-*Anemia
-*Mild leukocytosis
 | style="background: #F5F5F5; padding: 5px;" |
-*ECG is done rule out the heart failure as RA is one of the causes of heart failure
+* T-wave inversion
-| style="background: #F5F5F5; padding: 5px;" |
+* ST-segment depression
-*Plain film radiography: periarticular osteopenia, joint space narrowing, and bone erosions
+*  ST-segment elevation rarely
-*MRI: Bone erosions
+* Q-waves
-*Ultrasonography: Degree of inflammation and the volume of inflamed tissue
-| style="background: #F5F5F5; padding: 5px;" | ---
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Ankylosing spondylitis]]<ref name="pmid22798267">{{cite journal |vauthors=Ramonda R, Lorenzin M, Lo Nigro A, Vio S, Zucchetta P, Frallonardo P, Campana C, Oliviero F, Modesti V, Punzi L |title=Anterior chest wall involvement in early stages of spondyloarthritis: advanced diagnostic tools |journal=J. Rheumatol. |volume=39 |issue=9 |pages=1844–9 |date=September 2012 |pmid=22798267 |doi=10.3899/jrheum.120107 |url=}}</ref><ref name="pmid23678156">{{cite journal |vauthors=Wendling D, Prati C, Demattei C, Loeuille D, Richette P, Dougados M |title=Anterior chest wall pain in recent inflammatory back pain suggestive of spondyloarthritis. data from the DESIR cohort |journal=J. Rheumatol. |volume=40 |issue=7 |pages=1148–52 |date=July 2013 |pmid=23678156 |doi=10.3899/jrheum.121460 |url=}}</ref><ref name="pmid1488919">{{cite journal |vauthors=Jurik AG |title=Seronegative anterior chest wall syndromes. A study of the findings and course at radiography |journal=Acta Radiol Suppl |volume=381 |issue= |pages=1–42 |date=1992 |pmid=1488919 |doi= |url=}}</ref><ref name="pmid19604431">{{cite journal |vauthors=Guglielmi G, Cascavilla A, Scalzo G, Salaffi F, Grassi W |title=Imaging of sternocostoclavicular joint in spondyloarthropaties and other rheumatic conditions |journal=Clin. Exp. Rheumatol. |volume=27 |issue=3 |pages=402–8 |date=2009 |pmid=19604431 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Chronic (medical)|Chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Years
-| style="background: #F5F5F5; padding: 5px;" |Intermittent pain in
-*[[Vertebral column|Spine]] joint
-*[[Sacroiliac joint|Sacroiliac]] joint
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" |
-*Patients with [[Human leukocyte antigen|HLA]]-27 variant
+*[[Computed tomography|CT]]: Gastrointestinal inflamation
-*Extra-articular joint involvements
-*[[Restrictive lung disease|Restrictive pulmonary disease]]
-*Acute coronary syndromes (ACS), strokes, venous thromboembolism, conduction abnormalities
 | style="background: #F5F5F5; padding: 5px;" |
-* Genetics (Monozygotic twins)
+*CT Scan
-| style="background: #F5F5F5; padding: 5px;" |
+*Colonoscopy
-*[[Tenderness]] of the SI
+*biopsy
-*Limited spinal [[Range of motion|ROM]]
-*[[Schober's test|Schober test]]
-| style="background: #F5F5F5; padding: 5px;" |
-*↑ESR
-*↑CRP
-*↑ALP
-*↑IgA
-*[[Antigen]] HLA-27 positive
-*Negative Rheumatic Factor
-| style="background: #F5F5F5; padding: 5px;" |
-*ECG is done to rule out conductions defects and aortic insufficiency
-| style="background: #F5F5F5; padding: 5px;" |
-*Plain radiography: Erosions, ankylosis, changes in joint width, or sclerosis.
-*Magnetic resonance imaging (MRI): Osteitis" or "bone marrow edema" (BME)
-| style="background: #F5F5F5; padding: 5px;" |
-*Plain films of the sacroiliac joints
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Psoriatic arthritis]]<ref name="pmid1488919">{{cite journal |vauthors=Jurik AG |title=Seronegative anterior chest wall syndromes. A study of the findings and course at radiography |journal=Acta Radiol Suppl |volume=381 |issue= |pages=1–42 |date=1992 |pmid=1488919 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Chronic (medical)|Chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Years
-| style="background: #F5F5F5; padding: 5px;" |Asymmetrical intermittent pain in
-*[[Interphalangeal articulations of hand|Interphalangeal joints]]
-*Nails
-*Wrist
-*[[Knee|Knees]]
-*Ankles
-*Lower [[Human back|Back]]
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Psoriasis]]
-*[[Enthesitis]]
-*[[Tenosynovitis]]
-*[[Dactylitis]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Psoriasis
-* HLA-B*27 positive
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Dactylitis]] with sausage [[digits]]
-*Onycholysis
-*Pitting edema
-*Ocular involvement
-| style="background: #F5F5F5; padding: 5px;" |Non specific
-| style="background: #F5F5F5; padding: 5px;" |
-*Longer PR interval
-| style="background: #F5F5F5; padding: 5px;" |
-*X-ray: "pencil-in-cup" deformity, erosive changes and new bone formation, lysis of the terminal phalanges; fluffy periostitis
-*MRI: Detects articular, periarticular, and soft-tissue inflammation, enthesitis
-| style="background: #F5F5F5; padding: 5px;" |
-*X-ray
-|- style="background: #DCDCDC; padding: 5px;" |
-!Sternocostoclavicular [[hyperostosis]] (SAPHO syndrome)<ref name="pmid1488919">{{cite journal |vauthors=Jurik AG |title=Seronegative anterior chest wall syndromes. A study of the findings and course at radiography |journal=Acta Radiol Suppl |volume=381 |issue= |pages=1–42 |date=1992 |pmid=1488919 |doi= |url=}}</ref><ref name="pmid8484129">{{cite journal |vauthors=Saghafi M, Henderson MJ, Buchanan WW |title=Sternocostoclavicular hyperostosis |journal=Semin. Arthritis Rheum. |volume=22 |issue=4 |pages=215–23 |date=February 1993 |pmid=8484129 |doi= |url=}}</ref><ref name="pmid19772827">{{cite journal |vauthors=Magrey M, Khan MA |title=New insights into synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome |journal=Curr Rheumatol Rep |volume=11 |issue=5 |pages=329–33 |date=October 2009 |pmid=19772827 |doi= |url=}}</ref><ref name="pmid19479702">{{cite journal |vauthors=Colina M, Govoni M, Orzincolo C, Trotta F |title=Clinical and radiologic evolution of synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: a single center study of a cohort of 71 subjects |journal=Arthritis Rheum. |volume=61 |issue=6 |pages=813–21 |date=June 2009 |pmid=19479702 |doi=10.1002/art.24540 |url=}}</ref><ref name="pmid23597971">{{cite journal |vauthors=Carneiro S, Sampaio-Barros PD |title=SAPHO syndrome |journal=Rheum. Dis. Clin. North Am. |volume=39 |issue=2 |pages=401–18 |date=May 2013 |pmid=23597971 |doi=10.1016/j.rdc.2013.02.009 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Chronic (medical)|Chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Years
-| style="background: #F5F5F5; padding: 5px;" |Recurrent and multifocal pain in
-[[Sternoclavicular articulation|Sternoclavicular]] joint
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*Palmoplantar [[pustulosis]] (PPP)
-| style="background: #F5F5F5; padding: 5px;" |
-Positive family history of:
-* Spondyloarthritis
-* IBD
-* Psoriasis
-* Rheumatoid arthritis
-* Other autoimmune/autoinflammatory disease
-| style="background: #F5F5F5; padding: 5px;" |
-*Hyperostosis
-*Osteitis
-*Synovitis
-*Pustular eruptions
-*Inflammatory nodules or plaques
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Serology|Serologic]] testing to exclude other diseases
-*Non specific
-| style="background: #F5F5F5; padding: 5px;" |
-*ECG is done to rule out conductions defects and aortic insufficiency
-| style="background: #F5F5F5; padding: 5px;" |
-*Plain radiography: Hyperostotic changes (thickening of periosteum, cortex, and endosteum), sclerotic lesions, osteolysis, periosteal reaction, and osteoproliferation
-*Bone scan: "bull's head" change
-*Magnetic resonance imaging: Osteitis and soft tissue involvement
-*Fluorodeoxyglucose positron emission tomography (FDG-PET)/CT: Differentiates active versus inactive lesions
-| style="background: #F5F5F5; padding: 5px;" |
-*Bone scan
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Systemic lupus erythematosus]]<ref name="pmid6749397">{{cite journal |vauthors=Turner-Stokes L, Turner-Warwick M |title=Intrathoracic manifestations of SLE |journal=Clin Rheum Dis |volume=8 |issue=1 |pages=229–42 |date=April 1982 |pmid=6749397 |doi= |url=}}</ref> <ref name="pmid5015911">{{cite journal |vauthors=Hunder GG, McDuffie FC, Hepper NG |title=Pleural fluid complement in systemic lupus erythematosus and rheumatoid arthritis |journal=Ann. Intern. Med. |volume=76 |issue=3 |pages=357–63 |date=March 1972 |pmid=5015911 |doi= |url=}}</ref><ref name="pmid17283581">{{cite journal |vauthors=Porcel JM, Ordi-Ros J, Esquerda A, Vives M, Madroñero AB, Bielsa S, Vilardell-Tarrés M, Light RW |title=Antinuclear antibody testing in pleural fluid for the diagnosis of lupus pleuritis |journal=Lupus |volume=16 |issue=1 |pages=25–7 |date=2007 |pmid=17283581 |doi=10.1177/0961203306074470 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Chronic (medical)|Chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Years
-| style="background: #F5F5F5; padding: 5px;" |
-*Skin
-*[[Joint|Joints]] (fingers, wrist, knees)
-*[[Kidney|Kidneys]]
-*SLE can affect any organ of the body
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Human leukocyte antigen|HLA]]-genetic mutations
-*[[Female]] gender
-*Being younger than 50
-| style="background: #F5F5F5; padding: 5px;" |
-* Autoimmune conditions
-* Genetic predisposition
-* Positive family history
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Malar rash]]
-*[[Photosensitive]] [[rash]]
-*[[Discoid lupus|Discoid rash]]
-*[[Arthritis]] of the [[Proximal interphalangeal joints|proximal interphalangeal (PIP)]] and [[Metacarpophalangeal joint|metacarpophalangeal (MCP) joints]] of the [[hands]]
-*[[Pleural friction rub|Pleuro-pericardial friction rubs]]
-*[[Systolic murmurs]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Elevation of [[Autoantibody|autoantibodies]] ([[Antinuclear antibodies|ANA]], [[Anti-dsDNA antibody|anti-dsDNA]], [[Anti-SM antibody|anti-SM]], [[Antiphospholipid antibodies|antiphospholipid]])
-*[[Complement]] levels decreased
-*Anemia
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Sinus tachycardia]], [[ST segment changes]], and [[Ventricular arrhythmias|ventricular conduction disturbances]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Related to specific organ involvent
-| style="background: #F5F5F5; padding: 5px;" |
-*Anti-dsDNA antibody test
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Relapsing polychondritis]]<ref name="pmid23597963">{{cite journal |vauthors=Chopra R, Chaudhary N, Kay J |title=Relapsing polychondritis |journal=Rheum. Dis. Clin. North Am. |volume=39 |issue=2 |pages=263–76 |date=May 2013 |pmid=23597963 |doi=10.1016/j.rdc.2013.03.002 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |[[Chronic (medical)|Chronic]]
-| style="background: #F5F5F5; padding: 5px;" |Years
-| style="background: #F5F5F5; padding: 5px;" |Intermittent pain in:
-*[[Tissue (biology)|Tissues]] that cover the end of the [[Joint|joints]]
-*[[Cartilage]] of costal rib
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Hodgkin's lymphoma|Hodkin's lymphoma]]
-*[[Myelodysplastic syndrome|Myelodysplastic]] syndromes
-*[[Digestive disease|Gastrointestinal disorders]]
-*Type 1 [[Diabetes mellitus]]
-*[[Auricular appendage|Auricular]] [[chondritis]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Autoimmune diseases
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Physical examination|Physical examinations]] findings are seen related to [[nasal]] [[chondritis]], [[ocular]] [[inflammation]], [[cardiovascular disease]], [[skin disease]], [[CNS]] and [[Pulmonary|pulmonary system]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Negative [[Rheumatoid factor|rheumatoid]] factor
-*Anti-type II collagen antibodies
-*Antineutrophil cytoplasmic antibodies
-| style="background: #F5F5F5; padding: 5px;" |
-* ECG is done to rule out the cardiovascular complications of this disease
-| style="background: #F5F5F5; padding: 5px;" |
-*Non specific
-*Related to specific organ involvent
-| style="background: #F5F5F5; padding: 5px;" |
-*No gold standard test for this disease
-|- style="background: #DCDCDC; padding: 5px;" |
-|Psychiatric
-![[Panic attack]]/ Disorder<ref name="pmid10906353">{{cite journal |vauthors=Fleet RP, Martel JP, Lavoie KL, Dupuis G, Beitman BD |title=Non-fearful panic disorder: a variant of panic in medical patients? |journal=Psychosomatics |volume=41 |issue=4 |pages=311–20 |date=2000 |pmid=10906353 |doi=10.1176/appi.psy.41.4.311 |url=}}</ref><ref name="pmid7954018">{{cite journal |vauthors=Fleet RP, Dupuis G, Marchand A, Burelle D, Beitman BD |title=Panic disorder, chest pain and coronary artery disease: literature review |journal=Can J Cardiol |volume=10 |issue=8 |pages=827–34 |date=October 1994 |pmid=7954018 |doi= |url=}}</ref><ref name="pmid8068393">{{cite journal |vauthors=Simpson RJ, Kazmierczak T, Power KG, Sharp DM |title=Controlled comparison of the characteristics of patients with panic disorder |journal=Br J Gen Pract |volume=44 |issue=385 |pages=352–6 |date=August 1994 |pmid=8068393 |pmc=1238951 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |Acute or subacute or chronic
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*History of [[Depression]]
-*[[Panic attack|Panic attacks]]
-*[[Agoraphobia]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Psychiatric disorders
-| style="background: #F5F5F5; padding: 5px;" |
-*Anxious
-*Tachypneic
-| style="background: #F5F5F5; padding: 5px;" |
-*Thyroid function tests
-*Complete blood count
-*Chemistry panel
-| style="background: #F5F5F5; padding: 5px;" |
-*Sinus Tachycardia
-| style="background: #F5F5F5; padding: 5px;" |
-*No any specific radiographic test is done
-| style="background: #F5F5F5; padding: 5px;" | ---
-|- style="background: #DCDCDC; padding: 5px;" |
-| rowspan="2" |
-Others
-!Substance abuse
-([[Cocaine abuse|Cocaine]])<ref name="pmid26039070">{{cite journal |vauthors=Grant BF, Goldstein RB, Saha TD, Chou SP, Jung J, Zhang H, Pickering RP, Ruan WJ, Smith SM, Huang B, Hasin DS |title=Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III |journal=JAMA Psychiatry |volume=72 |issue=8 |pages=757–66 |date=August 2015 |pmid=26039070 |pmc=5240584 |doi=10.1001/jamapsychiatry.2015.0584 |url=}}</ref><ref name="pmid17592911">{{cite journal |vauthors=Cosci F, Schruers KR, Abrams K, Griez EJ |title=Alcohol use disorders and panic disorder: a review of the evidence of a direct relationship |journal=J Clin Psychiatry |volume=68 |issue=6 |pages=874–80 |date=June 2007 |pmid=17592911 |doi= |url=}}</ref><ref name="pmid2183544">{{cite journal |vauthors=George DT, Nutt DJ, Dwyer BA, Linnoila M |title=Alcoholism and panic disorder: is the comorbidity more than coincidence? |journal=Acta Psychiatr Scand |volume=81 |issue=2 |pages=97–107 |date=February 1990 |pmid=2183544 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |Acute (hours)
-| style="background: #F5F5F5; padding: 5px;" |Minutes to hours
-| style="background: #F5F5F5; padding: 5px;" |Pressure like pain in the center of chest
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Anxiety]]
-*[[Dyspnea]]
-*[[Nausea and vomiting|Nausea]]
-*[[Palpitation|Palpitations]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Psychiatric disorders
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Signs]] of [[injection]] [[drug use]]
-*[[Signs]] of [[drug]] [[inhalation]]
-*Poor [[personal hygiene]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Serum [[Cardiac biomarkers|biomarkers]] ([[Troponin I]], [[Troponin T]])
-*Toxicologic tests or drug screens of bodily fluids (blood, urine, saliva) and hairs
-| style="background: #F5F5F5; padding: 5px;" |
-**QT prolongation
-**Sinus Tachycardia
-**Arrhythmias
-**Cardiac conduction abnormalities
-| style="background: #F5F5F5; padding: 5px;" | ---
-| style="background: #F5F5F5; padding: 5px;" |
-*Gold standard test depends on the type of substance is abuse
-|- style="background: #DCDCDC; padding: 5px;" |
-![[Herpes Zoster]]<ref name="pmid17143845">{{cite journal |vauthors=Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, Betts RF, Gershon AA, Haanpaa ML, McKendrick MW, Nurmikko TJ, Oaklander AL, Oxman MN, Pavan-Langston D, Petersen KL, Rowbotham MC, Schmader KE, Stacey BR, Tyring SK, van Wijck AJ, Wallace MS, Wassilew SW, Whitley RJ |title=Recommendations for the management of herpes zoster |journal=Clin. Infect. Dis. |volume=44 Suppl 1 |issue= |pages=S1–26 |date=January 2007 |pmid=17143845 |doi=10.1086/510206 |url=}}</ref><ref name="pmid8545018">{{cite journal |vauthors=Oxman MN |title=Immunization to reduce the frequency and severity of herpes zoster and its complications |journal=Neurology |volume=45 |issue=12 Suppl 8 |pages=S41–6 |date=December 1995 |pmid=8545018 |doi= |url=}}</ref><ref name="pmid15897984">{{cite journal |vauthors=Jumaan AO, Yu O, Jackson LA, Bohlke K, Galil K, Seward JF |title=Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992-2002 |journal=J. Infect. Dis. |volume=191 |issue=12 |pages=2002–7 |date=June 2005 |pmid=15897984 |doi=10.1086/430325 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |Acute or Chronic
-| style="background: #F5F5F5; padding: 5px;" |Variable
-| style="background: #F5F5F5; padding: 5px;" |Burning pain on
-*Chest
-*Upper back
-*Lower back
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-*People who had [[chickenpox]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Immunosuppression
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Painful]] grouped herpetiform [[vesicles]] on an [[Erythematous|erythematous base]] distributed in a single [[dermatome]]
-| style="background: #F5F5F5; padding: 5px;" |
-*Viral culture
-*Direct immunofluorescence testing,
-*Polymerase chain reaction assay (PCR)
-| style="background: #F5F5F5; padding: 5px;" |
-*ECG is done to rule out other cardiovascular causes of chest pain
-| style="background: #F5F5F5; padding: 5px;" |
-*Magnetic resonance imaging (MRI): To rule out encephalitis
-| style="background: #F5F5F5; padding: 5px;" |
-*Viral tissue culture
 |}
 </small></small>

Cardiogenic shock differential diagnosis: Difference between revisions

Latest revision as of 13:14, 16 April 2020

Overview

Differential Diagnosis

References

Navigation menu