Chest pain natural history, complications and prognosis
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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 stress (physical or emotional.
- 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.
Complications
- Common complications of chest pain include:
- Arrythmia
- Heart failure
- Death
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.