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Chest pain

Descripción

Chest pain Mapa Mental sobre Chest pain, creado por sicilia_sp el 14/10/2013.
sicilia_sp
Mapa Mental por sicilia_sp, actualizado hace más de 1 año
sicilia_sp
Creado por sicilia_sp hace más de 12 años
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Resumen del Recurso

Chest pain
  1. Differential diagnosis
    1. Aged over 60
      1. ACS & Stable angina
        1. PE
          1. Pleurisy secondary to infection
            1. Oesophagitis secondary to GORD/hiatus hernia
              1. Anxiety
                1. Px
                  1. Boerhaave's perforation of OPS
                    1. Cholcystitis/pancreatitis
                      1. Aortic aneurysm
                      2. Younger pt
                        1. ACS & Stable angina
                          1. Myopericarditis( usually post-infarction)
                            1. Aortic dissection
                              1. Aortic aneurysm
                              2. Younger female on COC pill
                                1. PE
                                  1. Px( esp if tall and thin)
                                    1. Cocaine induced spasm( rare)
                                  2. Immediate assessment
                                    1. Assess ABC
                                      1. Reassure the pt
                                        1. Allow pt to sit/lie in whatever position is most comfortable
                                          1. Obtain a 12 lead ECG immediately(within 5-10 mins of arrival)
                                            1. High conc of oxygen by mask if oxygen sat is < 94% on air
                                              1. Connect pt to monitoring devices( ECG,BP, sats)
                                                1. Venous access and blds for routine tests. Samples for cardiac markers( usually 12 h after the onset of pain for troponins)
                                                  1. Request an urgent CXR/ consider need for early analgesia
                                                  2. Hx
                                                    1. SOCRATES for pain
                                                      2. Physical Exam
                                                        1. Pallor, sweating/cyanosis
                                                          1. Abnormal pulse/BP
                                                            1. Raised JVP/oedema
                                                              1. Added heart sounds
                                                                1. Changed resp rate and pattern
                                                                  1. Low sats
                                                                    1. Reduced air entry and abnormal breath sounds
                                                                      1. Abdo tenderness-esp epigastric and renal pain( which may mimic chest pain) and hepatic discomfort( CCF)

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