Term
| The "serious six" of chest pain (these are the potentially lethal causes, and thus must be worked up first) |
|
Definition
1) Acute coronary syndrome
2) Pericarditis/Cardiac tamponade
3) Pulmonary embolism
4) Pneumothorax
5) Aortic dissection
6) Esophageal rupture
Other causes that are not life-threatening include GERD, aortic stenosis (pain w/ exertion & radiation to carotids), musculoskeletal pain (most common, usually costrochondral), panic attack, etc |
|
|
Term
| chest pain that radiates to both arms, an S3, and hypotension are clinical signs that have the highest likelihood ratio for what? |
|
Definition
|
|
Term
| which 3 types of patients can present with atypical symptoms during an MI (e.g. diaphoresis w/out chest pain) |
|
Definition
| Diabetics, Women, & Elderly |
|
|
Term
| is "stabbing" chest pain associated w/ MI? |
|
Definition
no, in fact this is a negative predictor (0.3)
other negative predictors include:
- negative ECG
- positional chest pain
- pain w/ palpation |
|
|
Term
| resting (prinzmetal) angina and cocaine-induced coronary vasospasm can cause what type of ECG? |
|
Definition
| ST elevation (i.e. transmural ischemia) without evidence of direct myocardial injury |
|
|
Term
| sharp stabbing substernal pain w/ radiation along trapezius ridge (bottom of the scapula) |
|
Definition
|
|
Term
| 3 parts of a pericardial friction rub |
|
Definition
atrial systole
ventricular systole
ventricular diastole |
|
|
Term
| PR depression indicates what? |
|
Definition
| pericarditis (or atrial injury according to wiki) |
|
|
Term
name disease:
- acute chest pain a few weeks after a upper respiratory infection
- acute chest pain a few days after an MI
- Acute chest pain a few weeks after an MI |
|
Definition
1) Pericarditis (probably viral, probably coxsackie)
2) ''
3) Dressler syndrome (rare) |
|
|
Term
| In patients with acute pericarditis, hospitalization is prompted by an associated: |
|
Definition
| MI, Pyogenic infection, Tamponade |
|
|
Term
| what is the treatment of choice for pericarditis in the absence of a specific cause |
|
Definition
| anti-inflammatory therapy (i.e. NSAIDS) |
|
|
Term
| pulse differential (i.e. diminished pulse on one side) is an indication for what cardiac pathology? |
|
Definition
dissection; sensitivity is only 30%, but likelihood ratio is high (5.7)
another sign that may be seen is early diastolic murmur due to aortic insufficiency
you can also see focal deficits in a neurologic exam (from extension into carotids or decreased carotid blood flow). in fact, a patient may even present with neurologic defects w/out chest pain |
|
|
Term
name location of dissection based on what you do:
1) Surgical emergency
2) reduce bp (e.g. B-blockers followed by nitroprusside, fenoldopam, or enalapril) |
|
Definition
1) Before the subclavian artery branch (DeBakey 1 & 2)
2) after subclavian artery branch (DeBakey 3) |
|
|
Term
| exertional chest pain (possibly w/ dyspnea, palpations, & syncope); auscultation shows crescendo-decrescendo murmur @ apex w/ radiation to the right carotid |
|
Definition
|
|
Term
| Syndrome X, wrt cardiac pathology? |
|
Definition
Angina-like chest pain in young women. Characterized by anginal symptoms, ST-depression on exercise testing, and normal coronary arteris on angiography. Cause of pain is unknown.
There is a STRONG correlation with psychiatric disorders such as panic anxiety
However, do not misdiagnose it, b.c. fibromyalgia, costochondritis and esophagitis may present similarly |
|
|
