Differential diagnosis: Chest pain

Cardiac causes

Other cardiac differentials = stable angina, tamponade, mitral valve prolapse, pulmonary hypertension, aortic stenosis, arrhythmias

Respiratory

Other

Other differentials = gastritis, peptic ulcer disease, acute cholecystitis, gastritis, pancreatitis, fibromyalgia, Tietze syndrome

Try some questions

A patient presents with severe sudden onset chest pain, tearing through to the back. What are you concerned about and what is the imaging modality of choice?

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The nurse checks the observations and performs an ECG. You note the the patient is hypotensive and the ECG shows electrical alternans. What is electrical alternans and what is the likely diagnosis?

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What are the clinical signs of cardiac tamponade?

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What are the different types of thoracic aortic dissection and how are they managed?

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Try some OSCE stations

  1. Chest pain history 1
  2. Chest pain history 2
  3. Acute assessment – chest pain
  4. STEMI A-E assessment
  5. Find more here

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