Chest Pain - Internal Medicine

Front 1

Risk factors for CAD include...

Back 1

diabetes mellitus
smoking
hypertension
hyperlipidemia
family history of CAD

Front 2

What is pleuritic pain

Back 2

Pain caused by inflammation of serosal surfaces, may be aggravated by movement or position.
Pleuritic pain is most often seen in pulmonary etilogies, pericarditis, and musculoskeletal disorders.

Front 3

What is visceral pain?

Back 3

Pain such as myocardial ischemia, pulmonary embolus, aortic dissection, from non- life threating causes

Front 4

Some diseases that often present with sharp pleuritic type pain are..?

Back 4

pneumothorax has an acute onset and is pleuritic and assocatied wit hdyspnea, mostly youg patients or those with underlying lung disease

pulmonary embolism is similar toe pneumothorax with pelurisy and dyspnea

pericarditis is pleuritic and positiona in nature and is classically releived by sitting forward.

Front 5

Patients with myocardial ischemia often present with...

Back 5

Patients with myocardial ischemia often present with a squeezing or pressure sensation and possibly with a burning sensation. Located substernally the pain classically radiates to the ulnar aspect of the left arm byt may also go up to to the jaw, shoulders, epgastrium, or back,. Brought on by exertion or emotional stress it usually lasts only minutes. Worrisome features include prolonged pain(>30 minutes) with myocardial infarction and rest pain iwth unstable angina.

Front 6

Aortic dissection presents with...

Back 6

abrupt pain that is most intense at onset, which distinguishes this "must not miss" diagnosis. Pain is often tear and radiates to the back.

Front 7

Unequal blood pressure between arms

Back 7

Unequal blood pressures between arms is an important feature for aortic dissection. Tachypnea is seen in pulmonary cases such as with pneumothorax or pumonary embilism

Front 8

Reproduction of the chest pain by palpation is ...

Back 8

Reproduction of the chest pain by palapation is a key feature of musculoskeletal causes. THis is inot the case in agnina, pulmonary embolus, aortic dissection or true pleuritic diseases.

Front 9

Cardiac findings for ischemic heart disease include...

Back 9

Cardiac finding nclude a fourth hear t sound (ischmia) an apical hososystolic murmur (ischemic mitral regrtitaion) a blowing diastolic murmur (aortic reurgitation as result of

Front 10

Pulmonary findings of a pneumothorax include...

Back 10

Pulmonary findings of a pneumothorax include hyperresonance to percussion, decreased fremitus, and tracheal deviation to the opposite side. A pleural rub may indicate pulmonary infarcton or pneumonia

Front 11

Q waves in two or more leads

Back 11

previous myocardial infarcton

Front 12

ST depression > 1 mm

Back 12

ischemia

Front 13

ST elevation

Back 13

acute myocardial infarction or pericarditis (the latter often ahs invovlmenent of all leads and assocaiated PR depression)

Front 14

Left bundle branch block

Back 14

suggests underlying heart disease (ischemic, hypertensive)