Chest Pain
Life-threatening causes:
1. aortic dissection
2. MI
3. PE
4. tension pneumothorax
Differential diagnosis:
Cardiovascular:
- cardiac (IHD - ischaemic heart disease) = angina pectoris / ACS / MI
- rare cardiac = aortic stenosis / mitral valve prolapse
- pericardial = pericarditis / Dressler’s syndrome
- vascular = aortic dissection
Pulmonary:
- lung = PE / pneumonia
- pleural = pneumothorax (tension / non-tension)
Gastrointestinal:
- gastrooesophageal = GORD / oesophageal spasm / oesophageal rupture / GU / DU
- biliary = cholecystitis
Abdominal:
- 'crises' = pancreatitis / ruptured AAA
Musculoskeletal:
- bones = rib #
- joints = costochondritis / Tietze’s syndrome / arthritis (spinal, shoulder)
- muscles = fibromyalgia / traumatic muscle pain
Neurological:
-nerve root compression
-herpes zoster - VZV - (shingles)
Psychological:
- anxiety / depression
- hyperventilation
Diagnostic protocol:
