Chest pain natural history, complications and prognosis: Difference between revisions
Jump to navigation
Jump to search
| Line 15: | Line 15: | ||
*Associated [[symptoms]] such as [[shortness of breath]], [[nausea]] or [[vomiting]], [[lightheadedness]], [[confusion]], [[presyncope]] or [[syncope]], or [[vague]] [[abdominal]] symptoms are more frequently seen among [[patient]]s with [[diabetes]], [[women]], and the [[elderly]]. | *Associated [[symptoms]] such as [[shortness of breath]], [[nausea]] or [[vomiting]], [[lightheadedness]], [[confusion]], [[presyncope]] or [[syncope]], or [[vague]] [[abdominal]] symptoms are more frequently seen among [[patient]]s with [[diabetes]], [[women]], and the [[elderly]]. | ||
*A detailed assessment of [[cardiovascular]] [[risk factors]], review of [[systems]], [[past medical history]], and [[family]] and [[social history]] should be done in [[patients]] with [[chest pain]]. | *A detailed assessment of [[cardiovascular]] [[risk factors]], review of [[systems]], [[past medical history]], and [[family]] and [[social history]] should be done in [[patients]] with [[chest pain]]. | ||
*It is pivotal to identify and triage the [[patients]] presented with [[chest pain]] within 10 minutes of arrival to the [[hospital]]. | |||
* [[Patients]] diagnosed with [[STEMI]] should be echeduled for primary [[PCI]]. | |||
* Early recognition of [[STEMI]] may improve [[outcomes]]. | |||
* [[Stable angina]] and non-cardiac [[chest pain]] should be evaluated in [[outpaient]] setting. | |||
| Line 42: | Line 46: | ||
*[[Prognosis]] is generally good. <ref name="pmid29275346">{{cite journal |vauthors=Ilangkovan N, Mickley H, Diederichsen A, Lassen A, Sørensen TL, Sheta HM, Stæhr PB, Mogensen CB |title=Clinical features and prognosis of patients with acute non-specific chest pain in emergency and cardiology departments after the introduction of high-sensitivity troponins: a prospective cohort study |journal=BMJ Open |volume=7 |issue=12 |pages=e018636 |date=December 2017 |pmid=29275346 |pmc=5770919 |doi=10.1136/bmjopen-2017-018636 |url=}}</ref> | *[[Prognosis]] is generally good. <ref name="pmid29275346">{{cite journal |vauthors=Ilangkovan N, Mickley H, Diederichsen A, Lassen A, Sørensen TL, Sheta HM, Stæhr PB, Mogensen CB |title=Clinical features and prognosis of patients with acute non-specific chest pain in emergency and cardiology departments after the introduction of high-sensitivity troponins: a prospective cohort study |journal=BMJ Open |volume=7 |issue=12 |pages=e018636 |date=December 2017 |pmid=29275346 |pmc=5770919 |doi=10.1136/bmjopen-2017-018636 |url=}}</ref> | ||
*Depending on the etiology at the time of presentation, the prognosis may vary. However, the [[prognosis]] is generally regarded as good. | *Depending on the etiology at the time of presentation, the [[prognosis]] may vary. However, the [[prognosis]] is generally regarded as good. | ||
==References== | ==References== | ||
Revision as of 15:43, 23 December 2021
|
Chest pain Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Chest pain natural history, complications and prognosis On the Web |
|
FDA on Chest pain natural history, complications and prognosis |
|
CDC on Chest pain natural history, complications and prognosis |
|
Chest pain natural history, complications and prognosis in the news |
|
Blogs on Chest pain natural history, complications and prognosis |
|
to Hospitals Treating Chest pain natural history, complications and prognosis |
|
Risk calculators and risk factors for Chest pain natural history, complications and prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]
Overview
Common complications of chest pain include arrythmia, heart failure and Death. Depending on the etiology at the time of presentation, the prognosis may vary. However, the prognosis is generally regarded as good.
Natural history, Complications, and Prognosis
- Angina pectoris is defined as a retrosternal chest discomfort that increases gradually in intensity (over several minutes)
- Percipitant factors are physical or emotional stress.
- In ACS, chest pain may occur during rest.
- Chest pain is characterized by radiation (left arm, neck, jaw) and its associated symptoms (dyspnea, nausea, lightheadedness).
- When actively treated or spontaneously resolving, it disappears over a few minutes.
- Relief with nitroglycerin is not necessarily a diagnostic criterion of myocardial ischemia, especially because other causes such as esophageal spasm may have respons to nitroglycerin.
- Associated symptoms such as shortness of breath, nausea or vomiting, lightheadedness, confusion, presyncope or syncope, or vague abdominal symptoms are more frequently seen among patients with diabetes, women, and the elderly.
- A detailed assessment of cardiovascular risk factors, review of systems, past medical history, and family and social history should be done in patients with chest pain.
- It is pivotal to identify and triage the patients presented with chest pain within 10 minutes of arrival to the hospital.
- Patients diagnosed with STEMI should be echeduled for primary PCI.
- Early recognition of STEMI may improve outcomes.
- Stable angina and non-cardiac chest pain should be evaluated in outpaient setting.
Complications
- Common complications associated with lifethereatening causes of chest pain include:
- Arrythmia in the setting of ACS, PTE
- Heart failure in the setting of STEMI, NSTE-ACS, aortic dissection
- Cardiac arrest in the setting of massive PTE, aorta dissection, acute MI
Prognosis
- Prognosis is generally good. [1]
- Depending on the etiology at the time of presentation, the prognosis may vary. However, the prognosis is generally regarded as good.
References
- ↑ Ilangkovan N, Mickley H, Diederichsen A, Lassen A, Sørensen TL, Sheta HM, Stæhr PB, Mogensen CB (December 2017). "Clinical features and prognosis of patients with acute non-specific chest pain in emergency and cardiology departments after the introduction of high-sensitivity troponins: a prospective cohort study". BMJ Open. 7 (12): e018636. doi:10.1136/bmjopen-2017-018636. PMC 5770919. PMID 29275346.