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B2-1 Differential Diagnosis of Chest Pain
n/a
12
Medical
Graduate
09/19/2012

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Cards

Term
What are the features of classic stable Angina?
Definition
Defining feature is worsening with exertion, characterized by substernal pain w/radiation to left arm, jaw, or shoulder, may occur after eating or with cold exposure
Term
What are the features of unstable Angina?
Definition
Similar to classical, sudden onset, changes occur in quality, intensity, frequency, and duration of the pain, characteristically occurs at rest, refractory to therapy
Term
What is the key factor in mixed Angina?
Definition
Not progressive in severity
Term
What are some risk factors for Angina?
Definition
Hypertension, diabetes, hyperlipidemia, smoking, family history, males, age, postmenopausal women
Term
What are some common signs of atherosclerosis?
Definition
Cloudy ring of cholesterol surrounds the eye (Arcus senilis), optic fundi shows AV knicking, atrophic skin changes, bruits (swishing sound), S3 or S4, systolic murmurs, pulmonary rales, elevated or depressed ST on cardiogram, enlarged cardiac shadow on a CXR, hyperlipidemia
Term
What are the features of Pericarditis?
Definition
Substernal pain, constant without relief, pericardial friction rub, dyspnea and tachycardia w/tamponade, not associated with physical exertion, relieved by sitting forward (*unique feature), NO sign of atherosclerosis, often seen with rheumatoid arthritis
Term
What kind of labs would you see with Pericarditis?
Definition
Increased erythrocyte sedimentation, positive inflammatory markers, diffuse ST segments elevated in EKG
Term
Mitral valve prolapse is most common in what demographic?
Definition
Young women
Term
What is the classic characteristic finding for mitral valve prolapse?
Definition
Mid-systolic click and murmur, distinguished by family history, generally characterized by substernal chest pain w/dyspnea and possible pectus excavatum
Term
What are the characteristics of pulmonary embolism?
Definition
Sudden onset of unilateral chest pain, severe dyspnea, tachycardia, tachypnea, possible pleural rub
Term
What are the characteristics of esophageal spasm?
Definition
Very difficult to differentiate from coronary disease, classically unrelated to exertion, onset is with specific body position and frequent association with reflux, characterized by substernal or epigastric pain, usually after eating
Term
How are esophageal spasms diagnosed?
Definition
Upper GI barium swallow, esophageal manometry, EKG and labs tend to be normal
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