Chest Pain Assessment in Patients

Aug 15, 2024

Lecture on Chest Pain in Patient Assessment

Introduction

  • Focus on types of chest pain in medical patient assessment.
  • Detailed analysis of symptoms and treatments.

Classic Cardiac Chest Pain

  • Description: Crushing, dull, achy pain like "elephant sitting on the chest."
    • Typically on the left side, can be global.
    • Pain may radiate to the left arm and neck.
  • Symptoms:
    • Quick onset.
    • Difficulty breathing, weakness, nausea, vomiting, back pain.
  • Diagnostics:
    • All chest pain patients receive a 12-lead EKG.
  • Risk Factors:
    • More common in men.
    • Diabetics may not feel pain ("sneaky").
    • Smoking, age >40-50, diabetes, high blood pressure, high cholesterol, family history.

Pulmonary Embolism (PE)

  • Description: Often misdiagnosed; blockage in pulmonary artery.
  • Symptoms:
    • Tachycardia, difficulty breathing, chest pain, hypoxia.
    • Clot typically travels from a deep vein thrombosis (DVT).
  • Risk Factors:
    • Birth control, cancer, immobilization, long travel.
  • Diagnostics:
    • High heart rate, low SPO2, clear/diminished lung sounds.
    • "S1 Q3 T3" pattern on 12-lead EKG.

Pericarditis

  • Description: Inflammation around the heart, often due to infection.
  • Symptoms:
    • Pain worsens when leaning back, eases when leaning forward.
    • Sharp, knife-like pain.
  • Diagnostics:
    • PR depression and "smiling" ST upstroke on EKG.
    • Possible recent surgery or IV drug use.

Medical Pneumothorax

  • Description: Spontaneous lung collapse, often in young, tall, thin individuals.
  • Symptoms:
    • Sharp, sudden onset pain, difficulty breathing.
    • Diminished breath sounds on one side.
  • Signs of Severity: JVD, tracheal deviation.

Pneumonia

  • Description: Infection causing inflammation in lungs.
  • Symptoms:
    • Green/yellow sputum, fever, productive cough.
    • Rails initially, progresses to rhonchi.
  • Unilateral vs. Bilateral: More commonly unilateral, but bilateral possible.

Bonus: Anaphylaxis and Chest Pain

  • Could have chest pain due to tightness from wheezing.
  • Other symptoms: Stridor, nausea, vomiting, hives.

Conclusion

  • Understanding symptoms and risk factors is crucial for effective patient assessment and treatment.
  • Encouragement for further study and preparation for exams.

Additional Resource

  • Mention of a comprehensive 400+ video course for EMS preparation and patient care.