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CHEST PAIN (HISTORY (Radiaton - Does it go anywhere? Jaw, neck, arm, back,…
CHEST PAIN
HISTORY
Radiaton - Does it go anywhere? Jaw, neck, arm, back
Associations - Do you notice anything with pain? Nausea, Vomiting, Sweating, Fever, palpitation? cough?
characteristics - describe the pain for me? burning, sharp, stabbing
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DIFFERENTIAL DIAGNOSIS
CVS
Acute: STEMI, NSTEMI, aortic dissection, pericarditis
Chronic: Angina, valve abn
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RESPI
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Chronic: Malignancy, pneumonia, TB
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PHYSICAL EXAM
CVS - pulse, JVP, Apex beat, S1, S2, added sound, murmur
RESPI - nails, central cyanosis, breath sound, added sounds, tracheal deviation
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INVESTIGATIONS
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HAEMATOLOGICAL
FBC, Urea & electrolytes, LFT's, COAG, TnT, CK, CRP ?D Dimer
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CASES
63 y o lady presented with chest ,cough and fever for 2/7 days
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50 y o heavy smoker, presenting with central crushing chest pain while watching TV