chest discomfort

 

reference:

Toy, E. C., T., P., & Warner, M. T. (2009). Case files internal medicine. New York: MCGRAW-HILL.

credit: Medical City ER

Already have differential in mind? 

Focus on life threatening first!

 

DDX

Life threatening :

• ·        ACS – MI or unstable angina
• ·        Pulmonary embolism
• ·        Aortic dissection

Other differential:

Red flag pointers for acute chest pain

• Dizziness/syncope

• Pain in arms L>R, jaw

• Thoracic back pain

• Sweating

• Palpitations

• Dyspnoea

• Pain or inspiration

• Pallor

• Past history: ischaemia, diabetes, hypertension

Chest pain represents an acute coronary event until proved otherwise.

reference:

Talley, N. J., & O'Connor, S. (2013). Clinical examination: A systematic guide to physical diagnosis (7th ed.). London: Elsevier.

Hall, T. (2013). PACES for the MRCP: With 250 clinical cases (Third ed.). Edinburgh etc., Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto: Churchill Livingstone/Elsevier.

Haslett, C. (2018). Davidson’s Principles and Practise of Medicine. (23^rd Edition). London: Churchill Livingstone. 

 

to be continue....