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Revision as of 16:44, 30 November 2015


Differential Diagnosis History and Symptoms Physical Examination Laboratory Findings Imaging Findings
ST Segment Elevation Myocardial Infarction
  • Chest pain with possible radiation to left arm and lower jaw
  • Squeezing, crushing chest pain
  • Sweating
  • Nausea and vomiting
  • Anxious patient in pain with diaphoresis
  • Signs of heart failure may be present
  • Arrhythmia
  • ST elevation, new left bundle branch block, and Q wave on EKG
  • Elevated cardiac biomarkers
  • Either complete or subtotal occlusion of an epicardial coronary artery on coronary angiography
  • Confluent hyperenhancement extending from the endocardium
Non ST Elevation Myocardial Infarction
  • Crushing, left-sided substernal chest pain or pressure that radiates to the neck or left arm
  • Same as ST-elevation MI
  • ST-segment depression or T-wave inversion on EKG
  • Elevated cardiac biomarkers
Pericarditis
  • Chest pain relieved by sitting up and leaning forward and worsened by lying down
  • Fever, anxiety, difficulty breathing
  • Pericardial friction rub
  • Signs of cardiac tamponade may be present
  • PR segment depression and electrical alternans on EKG
  • A flask-shaped, enlarged cardiac silhouette on CXR
  • Pericardial thickness of more than 4 mm on MRI
  • Pericardial effusion and cardiac chamber indentation or collapse on echo when cardiac tamponade is present
Pulmonary Edema
  • Hemoptysis
  • Difficulty breathing, wheezing
  • Symptoms of fluid overload if pulmonary edema is chronic
  • Dyspnea, nasal flaring
  • End-inspiratory crackles
  • Third heart sound (S3)
  • Low oxygen saturation on ABG
  • Kerley B lines, increased vascular markings, interstitial edema, and peribronchial cuffing on CXR
  • Patchy alveolar infiltrates on CXR in noncardiogenic edema
Alcoholic Cardiomyopathy
Unstable Angina
  • Chest pain at rest










Subtypes of Myocarditis Histological Findings Clinical Presentation
Fulminant
  • Multiple foci of inflammation
  • Acute severe cardiovascular compromise with ventricular dysfunction
Acute
  • IDH1
  • p53
  • Gene on chromosome 10q
  • Gene on chromosome 17p
  • Gene on chromosome 19q
Chronic Active
Chronic Persistent