Chest pain resident survival guide: Difference between revisions
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== Definition== | ==Definition== | ||
[[Chest pain]] is [[discomfort]] or [[pain]] that is felt anywhere along the front of the body between the neck and the upper [[abdomen]]. | [[Chest pain]] is [[discomfort]] or [[pain]] that is felt anywhere along the front of the body between the neck and the upper [[abdomen]]. | ||
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==Do's | ==Do's== | ||
==Don'ts== | |||
==References== | ==References== | ||
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[[Category:Cardiology]] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Emergency Medicine]] | |||
[[Category:Medicine]] | [[Category:Medicine]] | ||
[[Category:Primary care]] | |||
[[Category:Resident survival guide]] | [[Category:Resident survival guide]] | ||
[[Category:Signs and symptoms]] | |||
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Revision as of 21:37, 11 August 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Definition
Chest pain is discomfort or pain that is felt anywhere along the front of the body between the neck and the upper abdomen.
Causes
Life-Threatening Causes
Life-threatening causes are conditions which result in immediate death or disability if left untreated.
- Aortic dissection
- Myocardial infarction
- Pericardial tamponade
- Pneumothorax
- Pulmonary embolism
- Unstable angina
Common Causes
- Biliary colic
- Costochondritis
- Cocaine induced coronary vasospasm
- Esophageal spasm
- GERD
- Myocardial infarction
- Panic attacks
- Pneumonia
- Stable angina
Management
Please find below an algorithm that summarizes the approach to chest pain.
| Check vital signs Stabilize the patient Order an EKG Concise history and physical exam | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Assess EKG | |||||||||||||||||||||||||||||||||||||||||||||||||||
| EKG consistent with ACS | EKG not consistent with ACS | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Order a CXR | |||||||||||||||||||||||||||||||||||||||||||||||||||
| STEMI Revascularization | NSTEMI Risk stratification | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Pneumothorax | Aortic dissection | No significant findings on CXR | |||||||||||||||||||||||||||||||||||||||||||||||||
| Control BP Obtain a CT scan Emergent surgery consult | Assess the pretest probability for pulmonary embolism | ||||||||||||||||||||||||||||||||||||||||||||||||||