Chest Pain
from EM Clerkship Hosted by Zack Olson, MD and Michael Estephan, MD
There are six cardiopulmonary causes of chest pain that you need to know. The SIX Causes * Cardiac* Acute coronary syndrome (ACS)* Pericarditis with tamponade* Pulmonary* Pneumonia* Pneumothorax* Vascular* Pulmonary embolism* Aortic dissection Step 1: Core Measures * Aspirin* EKG Step 2: Look for the “King” (Acute Coronary Syndrome) * Four high yield symptoms* Radiation to the RIGHT shoulder* Vomiting* Worsens with exertion* Diaphoresis Step 3: Look for the “Queen” (Pulmonary Embolism) * Wells score* PERC rule Step 4: Print a Previous Cath Report * Major bonus points with attending!* Other useful information* Previous echocardiograms* Previous stress tests* Previous CTAs for PE Step 5: Basic Testing Plan * If concerned for cardiac causes* Troponin* If concerned for pulmonary causes* Chest x-ray* If concerned for vascular causes* CTA of the chest Additional Reading * STEMI (EM Clerkship)* Pulmonary Embolism (EM Clerkship)
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