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Revision as of 14:22, 20 August 2012

ST Depression in a pt. with unstable angina

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Laboratory Findings

Electrolyte and Biomarker Studies

If there is an elevation of a marker of myocardial necrosis (CK-MB or troponin), then the patient does not have unstable angina, but instead has a syndrome of either ST elevation MI or Non ST elevation MI depending upon the EKG changes.

Electrocardiogram

ST Depression in a pt. with unstable angina

The resting electrocardiogram may show either

  1. No changes
  2. Flipped T waves
  3. ST Depression as shown to the right. ST depression carries the poorest prognosis.

Chest X Ray

A Chest X Ray is critical to aid in the exclusion of aortic dissection.

A mediastinal mass consistent with a cancer may be present, but it is unlikely to present with a syndrome of accelerating chest pain.

Differential Diagnosis of Chest Pain

Cardiovascular

References

  1. PMID 16046952
  2. PMID 17692756
  3. Bickley, LS (2003). Bates' Guide to Physical Examination and History Taking. Lippincott: Philadelphia, PA. ISBN 0781735114

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