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CHEST PAIN, Red flag symptoms :red_flag:, Potential causes, Worse lying…
CHEST PAIN
TESTS
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Possibly: Bloods - FBC, CRP
Potentially: OGD, USS abdomen
esophagitis, peptic ulcer, galsstones
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Potential causes
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Psychological, including anxiety
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Worse lying down?
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No
Angina, pulled muscle, costochondritis
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Worse on exertion?
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Possible
GORD, anxiety, muscle, costochondritis
Eased by rest?
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Possible
GORD, anxiety, costochondritis
Chest tenderness
No
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Yes
Pulled muscle, costochondritis
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If you feel worried enough to obtain an urgent ECG then you ought to consider whether the patient really requires an urgent medical opinion or admission.
:red_flag:
If in doubt, play safe: Give aspirin (if not allergic) and admit.
If the diagnosis remains unclear, examine the abdomen, especially for significant epigastric tenderness.
Symptoms of genuine and significant pathology may be clouded by various ensuing anxiety symptoms. Take time to tease them out.
Be especially careful dealing with acute chest pain in patients with asthma or COPD, especially if they are suddenly more SOB than usual, too – remember, they are more prone to developing a pneumothorax. :red_flag:
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