Medical Diagnosis And Management (Doctor Tips for chest pain)

COMMON CARDIOVASCULAR SYMPTOMS

CHEST PAIN

Chest pain is one of the most important emergencies; therefore it is necessary to evaluate chest pain thoroughly. It could be as serious as myocardial infraction (MI) or just muscular pain. Always think first and rule out life threatening conditions such as myocardial infarction, aortic, dissection, pulmonary, embolism and pneumothorax.(Health tips)

CAUSES OF CHEST PAIN
Cardiac	Vascular
Coronary artery disease such as angina, MI Aortic stenosis Pericardditis Hypertrophic cardiomyopathy	Pulmonary embolism Aortic dissection
Pulmonary	Gastrointestinal
Pleuritis Pneumonia Pneumothorax	Reflux esophagitis Esophageal spasm Peptic ulcer
Musculoskeletal	Others
Cervical disc disease Arthritis of shoulder or spine Costochondritis	Disorders of breast Herpes Zoster Emotional

CHEST PAIN DUE TO ANGINA PECTORIS

Angina means discomfort. Angina pectoris is usually described as heaviness, pressure, squeezing or sensation of constriction in the chest, but is may be described as aching or burning pain, difficulty in breathing or even an indigestion (gas trouble). In order to take good history you should know the difference between stable and unstable angina.

Anginal chest pain may be typical or atypical.

Typical chest pain:

• Typical pain of stable angina is the pain that develops gradually during exertion, after meal, with anger, excitement, frustration and other emotional states; it is not precipitated by coughing, respiratory movements or change in position.
• Anginal pain typically resolves within 5 to 30 minutes. More prolonged pain represents myocardial ischemia while more prolonged pain without evidence of myocardial ischemia suggests a non-cardiac pain.
• Anginal pain disappears usually after rest or within 5 minutes when sublingual nitroglycerine (Angised) is used.
• Angina typically occurs in retrosternal region, anteriorly across the midth
• orax. It may radiate to or rarely occur alone in the interscapular region, arms, shoulders, teeth, or abdomen.  
•                                                                   Dr. Inam Danish