Sandbox Maliha

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	Middle-aged man with history of alcohol abuse and shortness of breath on activity Fatigue, weakness, anorexia, and palpitations Leg swelling and pedal edema
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	EGFR
Chronic Persistent	TP53 PDGFRA IDH1