Term
| chest pain is the ______ most common presentation in ER; what percent of admissions are due to CAD |
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Definition
| second; less than 20% due to CAD |
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Term
| the likely etiology of chest pain can be formed based on: |
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Definition
| medical history, physical examination findings, and ECGs +/- an echocardiogram, or an exercise stress test |
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Term
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Definition
| all chest pain should be considered cardiac until proven otherwise |
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Term
| initial questioning the patient about cardiac-related symptoms include |
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Definition
| occurs with exertion, relieved at rest, relieved with nitroglycerin, associated with dyspnea, palpitations, dizziness or diaphoresis |
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Term
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Definition
| severe pain, crushing, squeezing, or pressure in your chest that lasts more than a few minutes or if the pain moves into your neck, left shoulder, arm or jaw |
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Term
| angina - what can it be caused by? |
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Definition
| chest pain related to an imbalance between oxygen demand of the heart and the amount of oxygen delivered via the blood; could be caused by spasm, narrowing, or partial block of an artery that supplies blood to the heart |
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Term
| what is ischemic chest pain characterized by? |
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Definition
recurrent retrosternal discomfort and pain or pressure that:
occurs with exertion
relieved at rest
relieved by nitroglycerin
associated with dyspnea, palpitations, dizziness, or diaphoresis |
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Term
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Definition
| occurs repetitively and predictably while exercising and goes away with rest |
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Term
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Definition
| results in unusual and unpredictable pain not totally relieved by rest |
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Term
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Definition
| persistent retrosternal discomfort and pain; etiology can be difficult to isolate; NOT due to diminished blood flow |
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Term
| pathophysiology of non ischemic chest pain |
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Definition
| overlapping cardiac, esophageal, musculoskeletal, and psychiatric abnormalities; with visceral hyperalgesia playin a central role |
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Term
| seven potentialy most life threatening causes of non-ischemic chest pain |
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Definition
acute aortic dissection
pulmonary embolism
pneumothorax
perforated viscus
acute pericarditis
pneumonia
cocaine induced chest pain |
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Term
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Definition
sudden sharp, severe "ripping or tearing"; spread of a subintimal hematoma within the wall of the aorta; radiates to the back between the scapulae
caused by damage to the innermost lining of the aorta: uncontrolled HBP, connective tissue diseases, cocaine use, advanced age, pregnancy, congenital heart disease, and cardiac catheterization |
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Term
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Definition
| sharp and sudden pain, shortness of breath, rapid breathing and sharp pain in the mid chest which may worsen on inspiration; other associated signs - hemoptysis, tachypnea, tachycardia |
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Term
| what are the risk factors to PE |
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Definition
| sedentary lifestyle, obesity, prolonged immobility, fracture of a longbone of the leg, pregnancy, cancer, history or family history of blood clots, irregular hear tbeats, heart attack, or congestive heart failure |
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Term
| pneumothorax (collapsed lung) |
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Definition
pressure balance between the sac that contains the lung and the outside atmosphere is disrupted
caused by trauma - injury to the chest that pierces through to the alveoli; sudden onset of pleuritic sharp, unilateral, chest pain and respiratory distress
sudden onset of shortness of breath, rapid HR, dizziness, faintness with complaints of painful breathing |
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Term
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Definition
| hole or tear in the wall of any area of the GI tract; allows air to enter the abdominal cavity which irritates the diaphragm, and can cause chest pain; caused by direct or indirect injury |
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Term
| risk factors for perforated viscus not related to trauma: |
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Definition
| untreated ulcers, prolonged or forceful vomiting, swallowing a foreign body, cancer, appendicitis, long term steroid use, infection of the gallbladder or gallstones |
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Term
| perforated viscus is characterized by |
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Definition
| sudden pain with severe abdominal, chest or back pain; abdominal pain may increase with movement or when breathing |
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Term
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Definition
retrosternal or left precordial chest pain that may radiate to the shoulder, neck, abdomen or back
pain is usually sharper than angina (stabbing); aggravated by coughing, inspiration or changes in position
worse in supine position; relieved by sitting upright or leaning forward |
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Term
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Definition
| sharp, knifelike pain aggravated by inspiration or coughing; may have a productive cough, fever, or chills, decreased appetite and activity |
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Term
| cocaine induced chest pain |
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Definition
| blood vessels in the body constrict; can decrease blood flow to the heart; accelerates the progression of athersclerosis |
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Term
| musculoskeletal causes of chest pain |
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Definition
unusual repetitive activity or an activity that strains the chest wall or spine
sharp localized pain that is persistent and often prolonged
reproducing the pain with either a specific movement or palpation of an affected structure |
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Term
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Definition
| gastrointestinal reflux disease (GERD), esphoageal spasm, esophagitis |
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Term
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Definition
| most common esophageal disorder, heartburn (pyrosis) - symptom of complex characterized by episodic substernal pain |
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Term
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Definition
| may occur with or without acid reflux; causes a squeezing chest pain that is virtually indistinguishable from angina |
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Term
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Definition
anxiety, panic disorder, or somatoform condtions
complaints of chest tightness or aching taht lasts more than 30 minutes |
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Term
| chest pain in children and adolescents |
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Definition
| history of sycope, presyncope, palpitations or previous cardiac surgery or family history of sudden death can suggest the possibility of cardiac origin of chest pain |
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Term
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Definition
an extremely rare event among the millions of children and adolescents who participate in athletics; <1 in 100,00 participants/year
usually from a previously undiagnosed underlying heart condition |
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Term
| chest pain with exercise associated with irregular or fast heart beat or associated with dizziness or syncope are symptoms that can indicate... |
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Definition
| a serious cardiac problem |
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Term
| chest pain that occurs at rest without other associated symptoms is not typically caused by |
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Definition
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Term
| over ____ % of children with chest pain have a benign condition that is not related to their heart |
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Definition
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Term
| annually physicians evaluate approximately _______ cases of chest pain in patients aged 10 -21 |
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Definition
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Term
| in a study of 50 children: ___% had pain from muscles, bones and cartilage, ___% had exercise induced asthma, ____ had pain from GI causes and ____ had pain from pyschogenic casues |
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Definition
| 76% from muscles, bones or cartilage, 12% had exercise induced asthma, 8% had GI causes, $% had psychogenic causes |
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Term
| cardiac related causes of chest pain in children and adolescents |
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Definition
less ventricular outflow tract obstruction - blockage of outflow of heart to body
hypertrophic cardiomyopathy (inherited)
anomalous coronary arteries - artery arising from the wrong sinus causing pain with exercise
rhythm disturbances - chest pain typically associate with feeling of heart beating too fast
pericarditis - often from virus |
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Term
| common causes of chest pain in children and adolescents |
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Definition
musculoskeletal
costochondritis - inflammation of the cartilage around the junction of the ribs to the breast bone
precordial catch syndrome
asthma
gastroesophageal reflux
anxiety |
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Term
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Definition
| related to strain or heavy lifting, injury to muscles and bone of chest wall, usually supportive treatment with rest and OTC meds |
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Term
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Definition
inflammation of the cartilage around the junction of the ribs to the breast bone that causes tenderness and pain of the anterior chest wall
common in adolescent females; most cases idiopathic
frequently caused by virus or frequent coughing
treatment: 1-2 week of OTC antiinflammatory med |
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Term
| precordial catch syndrome |
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Definition
sharb stabbing chest pain below the breast that lasts a few seconds and is worse with deep breath
may be from pinched nerve; occurs exclusively with inspiration; several episodes per day; frquency of events declines through adolescence |
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Term
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Definition
| burning pain worsened when lying down after eating, sometimes manifests as a burning sensation below the sternum, pain may vary in relation to meals |
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