Chest pain history and symptoms: Difference between revisions

Jump to navigation Jump to search
Line 10: Line 10:


*Describing the pain as heaviness, a pressure, discomfort or a bandilike tightness.
*Describing the pain as heaviness, a pressure, discomfort or a bandilike tightness.
*Radiation of the pain to [[neck]], [[jaw]], [[arms]], shoulders, back or upper abdomen.
*Radiation of the pain to [[neck]], [[jaw]], [[arms]], shoulders, back or upper abdomen.<ref name="pmid34709879">{{cite journal| author=Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK | display-authors=etal| title=2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2021 | volume= 144 | issue= 22 | pages= e368-e454 | pmid=34709879 | doi=10.1161/CIR.0000000000001029 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34709879  }} </ref>
*[[Diaphoresis|Sweating]]
*[[Diaphoresis|Sweating]]
*[[Nausea]]
*[[Nausea]]
Line 18: Line 18:
*[[Shortness of breath]]
*[[Shortness of breath]]
*A sense of impending doom.
*A sense of impending doom.
**Be mindful that women and patients with diabetes mellitus may present with the other symptoms rather than chest pain.
**Be mindful that women and patients with diabetes mellitus may present with the other symptoms rather than chest pain.<ref name="pmid34709879">{{cite journal| author=Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK | display-authors=etal| title=2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2021 | volume= 144 | issue= 22 | pages= e368-e454 | pmid=34709879 | doi=10.1161/CIR.0000000000001029 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34709879  }} </ref>


===Chest pain not characteristic of myocardial ischemia: <ref name="pmid203809602">{{cite journal| author=Yelland M, Cayley WE, Vach W| title=An algorithm for the diagnosis and management of chest pain in primary care. | journal=Med Clin North Am | year= 2010 | volume= 94 | issue= 2 | pages= 349-74 | pmid=20380960 | doi=10.1016/j.mcna.2010.01.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20380960  }}</ref>===
===Chest pain not characteristic of myocardial ischemia: <ref name="pmid203809602">{{cite journal| author=Yelland M, Cayley WE, Vach W| title=An algorithm for the diagnosis and management of chest pain in primary care. | journal=Med Clin North Am | year= 2010 | volume= 94 | issue= 2 | pages= 349-74 | pmid=20380960 | doi=10.1016/j.mcna.2010.01.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20380960  }}</ref>===

Revision as of 23:40, 14 December 2021

Chest pain Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Chest pain from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Chest Pain in Pregnancy

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Chest pain history and symptoms On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Chest pain history and symptoms

CDC on Chest pain history and symptoms

Chest pain history and symptoms in the news

Blogs on Chest pain history and symptoms

to Hospitals Treating Chest pain history and symptoms

Risk calculators and risk factors for Chest pain history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2], Nuha Al-Howthi, MD[3], José Eduardo Riceto Loyola Junior, M.D.[4]

Overview

The symptoms of chest pain can help to discern whether there is an underlying cause that may be dangerous. Symptoms that should cause alarm are; chest pain radiating to the back (aortic dissection), left arm or jaw pain, nausea, vomiting, lightheadedness, and angina pain that is different from baseline (myocardial infarction). Pain that is reproduced with palpation, greatest in the abdominal region, radiating to lower extremities, brought on by inspiration, or brought on any movement or postural changes, is less characteristic of myocardial ischemia.

History and Symptoms

Chest pain suggestive of cardiac ischemia as the underlying cause: [1]

Chest pain not characteristic of myocardial ischemia: [3]

  • Muscular pain; reproduced with or brought on by shoulder and/or forearm movements or postural changes,
  • Pleura related pain (pleuritic pain); a sharp or knife-like pain brought on by respiratory movements as deep breathing or cough
  • Primary or sole location of discomfort in the middle or lower abdominal region
  • Pain that may be localized at the tip of one finger, particularly over the left ventricular apex or a costochondral junction
  • Pain reproduced with movement or palpation of the chest wall or arms
  • Very brief episodes of pain that last a few seconds or less
  • Pain that radiates into the lower extremities

The relief of chest pain by administration of sublingual nitroglycerin in an outpatient setting is not diagnostic of coronary artery disease. For instance, esophageal pain can be relieved by the administration of nitroglycerin. Likewise, the relief of chest pain by the administration of liquid or chewable antacids and anti-reflux drugs does not exclude coronary artery disease as the underlying etiology of the pain.

References

  1. Yelland M, Cayley WE, Vach W (2010). "An algorithm for the diagnosis and management of chest pain in primary care". Med Clin North Am. 94 (2): 349–74. doi:10.1016/j.mcna.2010.01.011. PMID 20380960.
  2. 2.0 2.1 Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK; et al. (2021). "2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 144 (22): e368–e454. doi:10.1161/CIR.0000000000001029. PMID 34709879 Check |pmid= value (help).
  3. Yelland M, Cayley WE, Vach W (2010). "An algorithm for the diagnosis and management of chest pain in primary care". Med Clin North Am. 94 (2): 349–74. doi:10.1016/j.mcna.2010.01.011. PMID 20380960.