Chest pain echocardiography and ultrasound
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]
Overview
There are no echocardiography/ultrasound findings associated with [disease name].
OR
Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
Echocardiography/Ultrasound
Electrocardiography
An electrocardiogram is very usefel for the diagnosis of several etiologies of chest pain such as;
Acute coronary syndrome
- A standard 12 lead ECG is recommended in all patients with chest pain within 10 minutes of presentation if acute coronary syndrome is suspected[1][2].
- Findings on ECG suggestive of ACS include[3][4], ST elevation, ST depression and a new left bundle branch block (LBBB)
- It is important to note that a normal ECG does not rule out the presence of an acute myocardial infarction as ECG can show a hyperacute T wave.[5][6] Hyperacute T waves need to be distinguished from the peaked T waves associated with hyperkalemia.[7] as an early presentation.
- If an initial ECG is nondiagnostic and there is still a high clinical suspicion of an MI, a repeat ECG should be conducted.
- It is helpful to have precious ECGs of a patient to determine if findings observed are new.
References
- ↑ Slater DK, Hlatky MA, Mark DB, Harrell FE, Pryor DB, Califf RM (October 1987). "Outcome in suspected acute myocardial infarction with normal or minimally abnormal admission electrocardiographic findings". Am. J. Cardiol. 60 (10): 766–70. doi:10.1016/0002-9149(87)91020-4. PMID 3661390.
- ↑ Brush JE, Brand DA, Acampora D, Chalmer B, Wackers FJ (May 1985). "Use of the initial electrocardiogram to predict in-hospital complications of acute myocardial infarction". N. Engl. J. Med. 312 (18): 1137–41. doi:10.1056/NEJM198505023121801. PMID 3920520.
- ↑ Lee TH, Cook EF, Weisberg M, Sargent RK, Wilson C, Goldman L (January 1985). "Acute chest pain in the emergency room. Identification and examination of low-risk patients". Arch. Intern. Med. 145 (1): 65–9. PMID 3970650.
- ↑ O'Gara, Patrick T.; Kushner, Frederick G.; Ascheim, Deborah D.; Casey, Donald E.; Chung, Mina K.; de Lemos, James A.; Ettinger, Steven M.; Fang, James C.; Fesmire, Francis M.; Franklin, Barry A.; Granger, Christopher B.; Krumholz, Harlan M.; Linderbaum, Jane A.; Morrow, David A.; Newby, L. Kristin; Ornato, Joseph P.; Ou, Narith; Radford, Martha J.; Tamis-Holland, Jacqueline E.; Tommaso, Carl L.; Tracy, Cynthia M.; Woo, Y. Joseph; Zhao, David X. (2013). "2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction". Journal of the American College of Cardiology. 61 (4): e78–e140. doi:10.1016/j.jacc.2012.11.019. ISSN 0735-1097.
- ↑ Somers MP, Brady WJ, Perron AD, Mattu A (2002). "The prominant T wave: electrocardiographic differential diagnosis". Am J Emerg Med. 20 (3): 243–51. PMID 11992348. Unknown parameter
|month=ignored (help) - ↑ Smith SW, Whitwam W. "Acute Coronary Syndromes." Emerg Med Clin N Am 2006; 24(1): 53-89. PMID 16308113
- ↑ "The clinical value of the ECG in noncardiac conditions." Chest 2004; 125(4): 1561-76. PMID 15078775