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Ch. 47
Common causes of chest pain
| Cause | signs and symptoms | Typical Emergency Managment |
|---|---|---|
| angina | pain, squeezing, or heaviness in the chest, jaw, left arm, or left shoulder that isn't relived by nitro; dyspnea, diaphoresis, nausea, in female pt: all of the above or back pain, syncope, gastric symptoms, heart palpitations | administer nitro and O2, provide restful environment |
| gastroesophageal reflux disease | belching with heartburn triggered by large meals, spicy food, alcohol, and eating before bedtime; worsening of symptoms about 1 hour after meals | not an emergency, tests may rule out cardiac causes, treatment includes GI evaluation and medication to reduce stomach acid production |
| pericarditis | chest pain that is worse with inspiration; fever, malaise, dyspnea, chills | not an emergency; tests to rule out cardiac causes; treatment includes anti-inflammatory medication and possibly antibiotics |
| cholecystitis | colicky epigastric pain that radiates to the right upper quadrant, right shoulder and back; nausea, vomiting, fever, jaundice and pruritus, tachycardia, light stools and dark urine | not an emergency although pain maybe severe, tests may rule out cardiac causes, pt maybe hospitalized for cholecystectomy or lithotripsy |
| costochondritis | chest pain over the sternum that may radiate into the shoulders and arms and is worse with a deep breath, tenderness on or around the sternum to palpation | not an emergency, usually identified by a brief physical exam, tests may rule out cardiac cause, treatment includes nsaids, and ice |
| pulmonary embolism | chest pain with inspiration, cough, low-grade fever, dyspnea, tachypnea, occasional hemoptysis, cyanosis, shock | monitor ABC, administer O2 and ventilator support prn, measures to rule out cardiac cause may include EKG and cardiac enzyme studies |
| spontaneous pneumothorax | sudden sharp pleuritic chest pain, mild to moderate dyspnea, decreased breath sounds on affected side, decreased O sat, tachycardia, tachypnea, anxiety | O2 as ordered, position pt for comfort and optimal lung expansion, chest x-ray to confirm, prepare to assist w/ chest tube or Heimlich valve placement, pt may be transported to hospital for further care |
| panic attack | sudden onset of chest palpations, tachycardia, tachypnea, diaphoresis, trembling, dyspnea, chest pain, nausea, paresthesias, dizziness, chills, or hot flashes; feelings of anxiety or impending doom | not an emergency, tests may rule out cardiac or GI causes, treatment may include reassurance and anti-anxiety meds |
| myocardial infarction | pain, squeezing, or heaviness in the chest, jaw, left arm, or left shoulder that isn't relived by nitro; dyspnea, diaphoresis, nausea, in female pt: all of the above or back pain, syncope, gastric symptoms, heart palpitations | ABC; administer O2, morphine, nitro, aspirin, thrombolytic, antiarrythmic meds per order; provide pt w/ restful environment; provide bcls or acls as needed |
Created by:
rewebb
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