Chestpain Ddx

Chest Pain Study online at quizlet.com/_5og0d

1/3 of these patients have normal coronary arteries

Variant/Prinzmetal angina

23.

Accompanied by N&V, diaphoresis, and SOB

Acute MI

24.

Acute onset of pain, SOB, decreased breath sounds, and subtle edge on CXR

Pneumothorax

25.

Acute onset of severe, tearing pain

Aortic dissection

Angina at rest due to unstable plaque or vasoconstriction

Unstable angina

Aortic regurg murmur

Proximal aortic dissection

Associated with anterior MIs

Mobitz Type II, complete heart block

Associated with inferior MIs

Bradycardia, first-degree AV blocks, Mobitz Type I

Beck's Triad

Pericardial Tamponade

Burning pain with acid taste

GERD/dyspepsia

11.

Can lead to mediastinitis

12.

Cardiac risk factors

1.

2.

3.

4.

5.

6. 7.

8.

9. 10.

Don't use this drug with RV infarction

NTG

Due to inadequate perfusion of the myocardium

Unstable angina

EKG findings for RV infarction

ST elevation in V4 on right-sided EKG

Exertional and relieved with sublingual NTG

Stable angina

27.

Friction rub

Pericarditis

28.

Improves GERD/dyspepsia

Antacids / GI cocktails

29.

Inverted T wave in lead 3

Pulmonary embolus

30.

Lavigne's sign

Clutching chest

31.

Location of HZ (shingles)

Thoracic

32.

Main utility of EKG

Detect MI

33.

May be worse after meals

GERD/dyspepsia

May present with pain before a rash develops

HZ (shingles)

35.

Med that relaxes smooth muscle

NTG

Esophageal Rupture (Boorhave's syndrome)

36.

MEDICAL EMERGENCY

Esophageal Rupture (Boorhave's syndrome)

DASH SHTS - DM, Age > 40, Sex, HTN, Smoker, Hypercholesterolemia, Truncal obesity, Sedentary lifestyle

37.

Platelet response to a rupture

Adhesion, activation, aggregation

Pneumonia: gradual or acute onset of pain?

Gradual

26.

34.

38.

13.

Cause of stable angina

Plaque rupture and thrombosis, vasoconstriction

39.

Positional or pleuritic chest pain

Pericardial Tamponade

14.

Chest pain at rest

Unstable angina, Variant/Prinzmetal angina

40.

PR depressions

Pericarditis

Chest pain at rest due to vessel spasm

Variant/Prinzmetal angina

Prodrome that women often present with for one month prior to MI

Fatigue, difficulty sleeping, SOB

Components of Beck's Triad

Hypotension, JVD, Distant/muffled heart sounds

42.

Q wave in lead 3

Pulmonary embolus

Constant retrosternal pain that is worse with lying flat and relieved by sitting forward

Pericarditis

43.

Reduces LV dysfunction

ACE-I

44.

RUQ pain

Cholecystitis

Sinus tachycardia on EKG with evidence of right heart strain

Pulmonary embolus

Decreased distal pulses or neurologic findings

Distal aortic dissection

Sites where fibrinogen connects and allow platelets to aggregate

Glycoprotein IIb/IIIa receptors

Decreases heart's oxygen demand

BB

ST elevations

Decreases mortality

ASA, ACE-I, BB, NTG

STEMI, Variant/Prinzmetal angina, Pericarditis

Don't give this drug with CHF or PVD

BB

48.

State between stable angina and MI

Unstable angina

Don't use this drug with inferior MI

Morphine

49.

Symptoms with inferior MI

Abdominal pain, N&V

15.

16.

17.

18.

19.

20. 21.

22.

41.

45.

46.

47.

50.

T wave inversions

Pericarditis, Pulmonary Embolus

51.

Tachycardia

Pericardial Tamponade

52.

Treatment for anxiety attack

SSRIs, NERIs

53.

Two components of Acute Coronary Syndrome

Unstable angina, MI

54.

Two most frequently missed MIs

Posterior, high lateral

55.

Vasodilatory

NTG, CCB

56.

What drug should you give for CHF?

ACE-I

57.

What should you not give to a pt who uses cocaine?

Beta Blocker

58.

When is oxygen not needed?

Not hypoxic, admitted, pain-free