DVT complete diagnostic approach resident survival guide: Difference between revisions
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{{familytree | | | | | | | | | A01 | | | | | |A01=Assess [[ECG]]}} | {{familytree | | | | | | | | | A01 | | | | | |A01=Assess [[ECG]]}} | ||
{{familytree | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| }} | {{familytree | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| }} | ||
{{familytree | | | B01 | | | | | | | | | | B02 |B01='''Presence of ST elevation '''<br> OR <br> '''ST depression in in at least two precordial leads V1-V4''' <br> OR <br> '''New LBBB'''|B02='''Absence of ST elevation'''}} | {{familytree | | | B01 | | | | | | | | | | B02 |B01='''❑ Presence of ST elevation '''<br> OR <br> '''❑ ST depression in in at least two precordial leads V1-V4''' <br> OR <br> '''❑ New LBBB'''|B02='''❑ Absence of ST elevation'''}} | ||
{{familytree | | | |!| | | | | | | | | | | |!| | | | | | | | }} | {{familytree | | | |!| | | | | | | | | | | |!| | | | | | | | }} | ||
{{familytree | | | |!| | | | | | | | | | | B03 | | | | | | | B03=<div style="float: left; text-align: left; width: 12em; padding:1em;"> ❑ Rule out life threatening conditions </div>}} | {{familytree | | | |!| | | | | | | | | | | B03 | | | | | | | B03=<div style="float: left; text-align: left; width: 12em; padding:1em;"> ❑ Rule out life threatening conditions </div>}} | ||
{{familytree | |,|-|^|-|.| | | |,|-|-|-|v|-|^|-|v|-|-|-|.| | }} | {{familytree | |,|-|^|-|.| | | |,|-|-|-|v|-|^|-|v|-|-|-|.| | }} | ||
{{familytree | C01 | | C03 | | |!| | | |!| | | |!| | | |!| | C01=<div style="float: left; text-align: left; width: 12em; padding:1em;">'''Does the patient have both of the following:'''<br> | {{familytree | C01 | | C03 | | |!| | | |!| | | |!| | | |!| | C01=<div style="float: left; text-align: left; width: 12em; padding:1em;">'''Does the patient have both of the following:'''<br> | ||
❑ | ❑ ST elevation in at least 2 contiguous leads of 2 mm (0.2 mV) in men or 1.5 mm (0.15 mV) in women in leads V2–V3 and/or of 1 mm (0.1mV) in other contiguous chest leads or the limb leads<br>OR <br> | ||
❑ | ❑ ST depression in at least two precordial leads V1-V4 (suggestive of posterior MI)<br>OR <br> | ||
❑ ST depression in several leads plus ST elevation in lead aVR (suggestive of occlusion of the left main or proximal LAD artery)<br>OR <br> | |||
❑ New LBBB </div> | |||
| C03=<div style="float: left; text-align: left; width: 15em; padding:1em;"> '''Does the patient have any of the following:''' <br> | | C03=<div style="float: left; text-align: left; width: 15em; padding:1em;"> '''Does the patient have any of the following:''' <br> | ||
❑ There is ST elevation in multiple leads that does not follow an anatomic distribution of coronary arteries (ST elevation is diffuse)<br> | ❑ There is ST elevation in multiple leads that does not follow an anatomic distribution of coronary arteries (ST elevation is diffuse)<br> |
Revision as of 14:55, 8 May 2014
Please find below an algorithm that summarizes the approach to chest pain.
Assess ECG | |||||||||||||||||||||||||||||||||||||||||||||||
❑ Presence of ST elevation OR ❑ ST depression in in at least two precordial leads V1-V4 OR ❑ New LBBB | ❑ Absence of ST elevation | ||||||||||||||||||||||||||||||||||||||||||||||
❑ Rule out life threatening conditions | |||||||||||||||||||||||||||||||||||||||||||||||
Does the patient have both of the following: ❑ ST elevation in at least 2 contiguous leads of 2 mm (0.2 mV) in men or 1.5 mm (0.15 mV) in women in leads V2–V3 and/or of 1 mm (0.1mV) in other contiguous chest leads or the limb leads | Does the patient have any of the following: ❑ There is ST elevation in multiple leads that does not follow an anatomic distribution of coronary arteries (ST elevation is diffuse) | ||||||||||||||||||||||||||||||||||||||||||||||
STEMI | Pericarditis | Aortic dissection | Pulmonary embolism | Tension pneumothorax | Esophageal rupture | ||||||||||||||||||||||||||||||||||||||||||
Look for supportive signs and symptoms: ❑ The pain is described as a heaviness or crushing sensation | Look for supportive signs and symptoms: ❑ Pleuritic pain | Look for supportive signs and symptoms: ❑ Back pain
| Look for supportive signs and symptoms: ❑ Shortness of breath | Look for supportive signs and symptoms: ❑ Sudden shortness of breath | Look for supportive signs and symptoms: ❑ Vomiting | ||||||||||||||||||||||||||||||||||||||||||
Click here for the detailed management | Click here for the detailed management | Click here for the detailed management | Click here for the detailed management | Click here for the detailed management | Click here for the detailed management | ||||||||||||||||||||||||||||||||||||||||||