Kategorier: Alle - pain - psychological - cardiac

av Kassidy Fretz 4 år siden

203

Chest Pain Differential

Various causes can contribute to chest pain, each with distinct characteristics and associated symptoms. Psychological factors, such as anxiety and panic attacks, can trigger chest pain, often accompanied by breathlessness, palpitations, and weakness.

Chest Pain Differential

Chest Pain

Non-cardiac

MSK
Pain may be reproducible on physical exam
No burning in esophagus
Psychological
Anxiety/panic attack

Also associated with breathlessness, palpitations, weakness, and anxiety

Aggravated by emotional stress

Stabbing, sticking, or dull and aching pain located precordial, below left breast, or across anterior chest

Esophageal
Visceral hyperalgesia

Also associated with constipation, bloating, diarrhea, and nausea/vomiting

Not normally associated with eating or lying down

Pain presentation ranges from sharp to dull or burning and may be constant or relapsing

Achalasia

Food is coming from esophagus, not stomach

Associated with dysphagia, regurgitation of food and liquids, coughing at night, and chest pain that comes and goes

GERD
Pulmonary
Tracheobronchitis

Associated with a cough

May be relieved by lying on affected side

Made worse by coughing, not food or lying down

Burning pain located upper sternal or on either side of sternum

Pleuritic pain

Persistent pain aggravated by deep inspiration, coughing, and movements of the trunk

Sharp, knife-like pain located on chest wall

Cardiac

Dissecting Aortic Aneurysm
Also associated with hoarseness, dysphagia, syncope, hemiplegia, and paraplegia
Aggravated by hypertension, not food or lying down
Would be an abrupt onset, early peak, and persist for hours or more
Ripping, tearing pain located on anterior chest and radiating to neck, back, or abdomen
Pericarditis
Sharp, knife-like or crushing pain located retrosternal or left precordial and may radiate to tip of left
Angina Pectoris/MI
Sometimes associated with dyspnea, nausea, sweating, weakness
Not persistent and at the same time (each night, after each meal)
Not normally associated with eating meals, beer, coffee, or lying down
Pressing or squeezing pain (not usually burning) located retrosternal or across anterior chest and sometimes radiating to shoulders, arms, neck, lower jaw, or upper abdomen