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Questions and Answers
What is the characteristic of cardiac pain due to pleura or pericardium?
What is the characteristic of cardiac pain due to pleura or pericardium?
Which of the following symptoms is unlikely to be associated with cardiac pain?
Which of the following symptoms is unlikely to be associated with cardiac pain?
What is the typical duration of chest pain that suggests M.I?
What is the typical duration of chest pain that suggests M.I?
What is the primary concern when evaluating a patient with chest pain?
What is the primary concern when evaluating a patient with chest pain?
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Which of the following is an exacerbating factor for angina pain?
Which of the following is an exacerbating factor for angina pain?
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Which of the following is NOT a cardiac cause of chest pain?
Which of the following is NOT a cardiac cause of chest pain?
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What is the characteristic of aortic dissection pain?
What is the characteristic of aortic dissection pain?
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What is the characteristic of the onset of pain in a myocardial infarction (M.I)?
What is the characteristic of the onset of pain in a myocardial infarction (M.I)?
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What is the underlying cause of dyspnea in cardiac pain?
What is the underlying cause of dyspnea in cardiac pain?
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Which question in the SOCRATES framework is used to assess the location of the pain?
Which question in the SOCRATES framework is used to assess the location of the pain?
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What is the characteristic of epigastric pain that is cardiac in origin?
What is the characteristic of epigastric pain that is cardiac in origin?
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What is the typical location of cardiac pain?
What is the typical location of cardiac pain?
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What is the underlying cause of chest pain associated with tenderness?
What is the underlying cause of chest pain associated with tenderness?
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Which of the following is a musculoskeletal disorder that can cause chest pain?
Which of the following is a musculoskeletal disorder that can cause chest pain?
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What is the purpose of using the SOCRATES framework in evaluating chest pain?
What is the purpose of using the SOCRATES framework in evaluating chest pain?
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Which of the following is NOT a lung and pleura cause of chest pain?
Which of the following is NOT a lung and pleura cause of chest pain?
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Study Notes
Chest Pain
- Chest pain may not be serious, but it's essential to consider life-threatening conditions like myocardial infarction (M.I), pulmonary embolism (P.E), dissecting aortic aneurysm, or pericarditis.
Causes of Chest Pain
- Anxiety or emotional
- Cardiac causes:
- Myocardial ischemia (angina)
- Myocardial infarction (M.I)
- Aortic stenosis
- Aortic aneurysm/aortic dissection
- Pericarditis/Myocarditis
- Mitral valve prolapse
- Lung and pleura causes:
- Bronchospasm
- Tracheitis
- Pneumonia
- Pulmonary infarction/pulmonary embolism (P.E)
- Pneumothorax
- TB
- Malignancy
- Connective tissue diseases
- GIT causes:
- Oesophagitis
- Oesophageal spasm
- Mallory-Weiss syndrome
- Musculoskeletal disorders:
- Arthritis
- Costochondritis
- Intercostal muscle injury
- Rib fracture or injury
- Epidemic myalgia (Bornholm disease) caused by Coxsackie viral infection
- Neurological disorders:
- Prolapsed intervertebral disc
- Herpes zoster
- Thoracic outlet syndrome
Analyzing Chest Pain with SOCRATES Questions
- Site:
- Cardiac pain is typically located in the center of the chest
- Onset:
- M.I develops gradually (takes several minutes or even longer)
- Angina develops gradually depending on the intensity of exertion
- P.E, pneumothorax, and aortic dissection pain are very sudden
- Character:
- Cardiac pain is constricting, dull, choking, or heavy pain
- Pain due to pleura or pericardium is sharp, stabbing, or knife-like pain
- Aortic dissection results in tearing, instantaneous pain
- Radiation:
- Ischemic cardiac pain typically radiates to the jaw, neck, either or both upper arms
- Aortic dissection pain is tearing, instantaneous interscapular pain
- Epigastric pain could be cardiac in origin
- Associated symptoms:
- Autonomic symptoms: nausea, vomiting, pallor, and sweating
- Dyspnea: result from left ventricular ischemia, P.E, lung and pleural disorders, and anxiety
- GIT symptoms: due to esophagitis, esophageal reflux, peptic ulcer, and biliary disease
- Timing/duration:
- Prolonged chest pain (>30 min) suggests M.I
- Exacerbating and relieving factors:
- Exacerbating: angina pain occurs during (not after) exercise, and cardiac pain occurs with palpitation, exposure to cold, after a heavy meal, and emotional stress
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Description
Identify the causes of chest pain, differentiating between cardiac and non-cardiac conditions, and learn how to diagnose them through history, physical examination, lab findings, and imaging techniques.
