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MUSCULOSKELETAL
CARDIOVASCULAR
OTHERS
CHEST PAIN
Cardiovascular
Angina Pectoralis
Myocardial Infarction
Pericarditic Pain
Aortic Pain
Angina Pectoris Retrosternal (radiates to arm and jaw),tight or pressing band-like similar to a heavy weight Precipitated by exertion and relieved with rest or nitrates, ache or dull comfort Not accompinied with heartburn last for about 2-10 min Its may radiate on both arms its throat, jaw and teeth Its unaffected by inspiration, twisting or turning
Myocardial Infarction Site similar as angina More severe and prolonged, sweating, pallor, nausea, vomiting, diarrhea Persists with rest, accompanied with restlessness, breathlessness and feeling of impending death (angor animi)
Pericarditic Pain
Sharp, raw or stabbing pain in the mid-chest, worsened by deep breaths Varies with movement or breathing, pain is worsened by lying flat and improved by leaning forward Many people report a recent cold, fever, shortness of breath, or pain when swallowing just before developing pericarditis.
Aortic Pain
Severe Pain Tearing and sudden in onset Radiates to the back (typically interscapular) Accompinied with profound autonomic stimulation
Pneumonia Symptoms
chest pain is pleuritic, hurting when taking a deep breath usually one-sided an is worsened by coughing associated symptoms include fever, coughing up mucus (sputum), and shortness of breath
Pneumothorax
acute onset of sharp chest pain associated with shortness of breath with no preceding illness or warning Physical examination reveals decreased air entry on the affected side
Pulmonary embolism
A blood clot to the lung, pleuritic chest pain, shortness of breath coughing up blood (hemoptysis) patient can also have anxiety and sweat profusely size of the clot, the initial presentation may be fainting (syncope) or a passing-out spell.
Pneumothorax
heartburn, painful swallowing, excessive salivation, dull chest discomfort, chest pressure, or severe squeezing pain across the mid chest. You may feel uncomfortable or may experience:
profuse sweating pallor nausea vomiting sour or bitter taste in the mouth or throat hoarseness, and persistent dry cough.
Esophagitis
Difficulty swallowing Painful swallowing The chest pain comes on suddenly and is not relieved by antacids.
Esophageal spasm
usually intermittent and dull It is located in the mid-chest radiate to the back, neck, or shoulders.
Musculoskeletal Pain
Maybe due to Fracture of ribs Metastatic deposits in the ribs Costochondritis Spinal root lesion Herpes Zoster
Costochondritis
This is an inflammation of the cartilage between the ribs Pain is typically located in the mid-chest with intermittently dull and sharp pain may be increased with deep breaths, movement, and deep touch
When did the pain start? What is the quality of the pain? How long does the pain last? Does the pain come and go? What makes the pain better? What makes the pain worse? Does the pain radiate somewhere (move to another area of the body)? Has there been any preceding illness? Has there been any trauma? Have there been similar episodes of pain in the past?
Head and neck Looking for neck vein distension or bulging Listening over the carotid arteries for bruits (abnormal sounds) or murmurs Chest wall Palpate for rib or muscle tenderness Look for rashes Lungs Listen for abnormal lung sounds or decreased air entry Heart Listen for abnormal heart sounds, murmurs or rubs (a friction sound made by two rough surfaces rubbing against each other, which may be seen with inflammation of the heart lining, called pericarditis) Listen for muffled heart tones Abdomen Palpate for tenderness or masses Listen for bruits over the aorta Extremities Feel for pulses
Conditions in the abdomen can present as pain referred to the chest, especially if there is inflammation along the diaphragm. Inflammation of the stomach, spleen, liver, or gallbladder can initially present with non specific pain complaints that may be associated with vague chest discomfort.