Common chest histories

• Crushing central chest pain
• Radiates to neck/left arm
• Associated nausea/SOB/sweatiness
• Cardiovascular risk factors

• Cardiac-type chest pain
• Associated with exertion
• Relieved by rest

• Tearing chest pain of very sudden onset
• Radiates to back
• Pain in other sites, e.g. arms, legs, neck, head

• Retrosternal/precordial pleuritic chest pain
• Relieved by sitting forward
• May radiate to trapezius ridge/neck/ shoulder

• Fever
• Palpitations
• Symptoms of heart failure

• Pleuritic chest pain
• SOB ± haemoptysis
• Risk factors (e.g. long haul flight, recent surgery, immobility, malignancy)

• Sudden onset pleuritic chest pain
• SOB if large enough
• Risk factors, e.g. tall/thin, Marfan syndrome, COPD/asthma

• • Retrosternal burning chest pain

• • Related to meals, lying, straining

• • Excessive salivation

• Tight chest pain, SOB, sweating, dizziness, palpitations, feeling of impending doom
• Anxious personality and other symptoms of generalised anxiety disorder
• Recurrent episodes triggered by a stimulus (e.g. crowds)

• Sharp chest pain
• Exacerbated by movement and inspiration
• Can point to where it is worst
• Exacerbated by pressure over area

• Costochondritis and Tietze’s syndrome (sharp pleuritic sternal pain with tenderness)
• Pleurisy (sharp unilateral pleuritic chest pain)
• Gastritis

• Acute onset SOB, often wakes them
• Associated nausea/sweatiness
• May have crushing central chest pain
• Cardiovascular risk factors

• SOB, orthopnoea, paroxysmal nocturnal dyspnoea
• Pink frothy sputum if acute LVF
• Peripheral oedema
• Cardiac history

• Exertional breathlessness/syncope

• Acute SOB, cough and sputum
• Systemic symptoms, e.g. fever

• Intermittent wheeze
• Diurnal variation
• Nocturnal cough
• Exacerbating factors, e.g. exercise, pets

• Chronic SOB and sputum production
• Significant smoking history

• Sudden onset pleuritic chest pain
• Risk factors, e.g. tall/thin, Marfan syndrome, COPD/asthma

• Pleuritic chest pain
• Haemoptysis
• Risk factors (e.g. long haul flight, recent surgery, immobility, malignancy)

• Progressive SOB over long period
• Dry cough

• Pleural effusion
• Lobar collapse
• Bronchiectasis
• Sarcoidosis
• TB
• Extrinsic allergic alveolitis

• Anaemia
• Hyperventilation in anxiety
• Pleural effusion
• Metabolic acidosis compensation, e.g. in DKA
• Bronchiectasis
• Aortic stenosis
• Neuromuscular causes

• Acute productive cough
• May have associated SOB
• Systemic symptoms, e.g. fever

• Nocturnal dry cough
• Intermittent wheeze
• Diurnal variation
• Exacerbating factors, e.g. exercise, pets

• Chronic rhinitis/sinusitis
• Chronic cough to clear throat

• Chronic productive cough
• Chronic SOB
• Significant smoking history

• Haemoptysis
• Weight loss
• Significant smoking history

• Bronchiectasis
• Interstitial lung disease
• Sarcoidosis
• TB
• Cystic fibrosis

• GORD
• Smoking
• Medication side effects (e.g. ACE inhibitor)
• Bronchiectasis
• Interstitial lung disease
• Sarcoidosis/TB
• Cystic fibrosis

• Acute productive cough
• May have associated SOB
• Systemic symptoms, e.g. fever

• Pleuritic chest pain and SOB
• Risk factors (e.g. long haul flight, recent surgery, immobility, malignancy)

• Weight loss
• Significant smoking history

• Weight loss
• Significant smoking history

• Chronic productive cough
• Recurrent chest infections
• Cause e.g. CF, childhood respiratory illness, TB, immunosuppression

• TB
• Aspergillosis 

• Bronchitis
• Mitral stenosis
• TB
• Laryngeal carcinoma
• Goodpasture’s syndrome
• Aspergilloma

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