Chest pain physical examination

Physical Examination

Vitals

• Temperature (pericarditis, pleuritis, fever can precipitate ischemic attacks)
• Absent or decreased pulses in limbs (aortic dissection all four limbs), tachycardia (pulmonary embolism)
• Blood pressure in both the arms (aortic dissection)

Neck

• Elevated jugular venous pulse

Cardiovascular

• Auscultation
  • Third and fourth heart sound
  • Carotid bruit
  • Pericardial rub (pericarditis)
  • Murmur (systoloic murmur in Hypertrohic cardiomyopathy, aortic stenosis)

Pulmonary

• Palpation - shift in trachea from midline (tension pneumothorax)
• Auscultation - Decreased breath sound (pulmonary edema), pleural rub (pleuritis, pneumonia)

Central nervous system

• Cerebrovascular accidents (aortic dissection)
• Paraplegia

Genitourinary system

• Rectal examination - occult bleeding (peptic ulcers)