Approach To Chest Pain
Approach To Chest Pain
Approach To Chest Pain
Abdulaziz Eshaq
Ahmad Fothan
Mario Sanad
Islam Elsayed
Objectives
• Definition
• Prevalence
• Causes
• History
• Physical exam
• Investigation
• Treatment
Definition
• Discomfort felt in the upper abdomen, thorax,
neck, or shoulders.
Critical Benign
What are the 6 cause of
chest pain that can kill?
Chest Pain That Can Kill
• Acute Coronary Syndromes
• Pulmonary Embolism
• Aortic Dissection
• Esophageal Rupture
• Pneumothorax
• Pneumonia
THE 3 A’s
• ACS
• Aortic dissection
• AAA
Common “benign”
causes of chest pain?
Benign Causes
• Musculoskeletal
• Esophagitis
• Bronchitis (Chest Pain secondary to cough)
• “Non-Specific Chest Pain” *
• Bech’s triad:
o Low blood pressure decreased stroke volume
o JVP distension impaired venous return
o Muffled sound because of fluid build up
Pulmonary Embolism
• Dyspnea at rest or with excretion, pleuritic pain,
cough
• Orthopnea, calf or thigh pain and swelling
• Focal neurologic signs in the setting of acute chest pain may be helpful in
diagnosing acute aortic dissection
• The initial goal in the office evaluation of chest pain
in stable individuals is to exclude acute coronary
syndrome (ACS) and other potentially life-
threatening conditions.
• CK-MB