Duke PA Chest Pain/Cardiac Emergency
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| show | Pleuritic chest pain
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| show | Pleurisy
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| Pleuritic chest pain, loud P2, right ventricular lift may indicated what | show 🗑
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| show | Pneumonia
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| show | Asthma/COPD
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| Severe respiratory distress, frothy pink or white sputum, rales, S3/S4, PND, orthopnea, edema may indicate what | show 🗑
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| show | Heartburn/GERD
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| show | Esophagus, and stomach
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| show | Hematemesis with or without prior vomiting episode
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| show | PUD
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| show | Esophageal perforation
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| show | Cholecystitis
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| show | Pancreatitis
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| Sharp pain, worse with movement/palpitation may be what | show 🗑
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| Rule out MI with serial __ | show 🗑
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| Deep, pressure-like pain in substernal region, may radiate to jaw, neck or left shoulder/arm. Frequently associated with SOB, transient, precipitated by physical exertion or stress, responsive to rest or SL NTG may be what | show 🗑
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| show | Negative
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| show | 81-325 ASA daily, beta blocker, ACE I, nitrates, statins
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| What does MOAN stand for in the treatment of unstable angina/NSTEMI | show 🗑
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| show | 1 hour
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| show | HTN or hypotension, tachy/bradycardia, S3 or S4 or both, systolic murmurs, friction rub (day 2 or 3)
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| show | 0-6
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| show | 0-18
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| show | 18
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| show | MI, aortic dissection, leaking AAA
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| show | Bicuspid aortic valve or coarctation of the aorta
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| >95% of aortic dissections occur in the __ | show 🗑
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| show | Any involvement of ascending aorta
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| show | Not involving ascending aorta
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| Sudden onset retrosternal and back pain, may see infarct pattern on ecg, neurologic deficits/CVA, limb ischemia, syncope, shock, hypertensive, pulse discrepancies, tamponade possible may indicate | show 🗑
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| Evaluation of acute aortic dissection includes what | show 🗑
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| Useful for serial follow-up of aortic dissection | show 🗑
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| show | Widened aortic silhouette, widened mediastinum, left pleural effusion, 10-20% are normal
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| show | Beta blocker then nitroprusside to maintain SBP of 100-120 mmHg
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| Type __ aortic dissection gets surgical repair | show 🗑
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| Type __ aortic dissection gets medical treatment | show 🗑
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| show | Rupture, limb or visceral ischemia, ongoing pain, saccular morphology, uncontrolled HTN, Marfan’s or AI (rare)
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| show | AAA
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| If suspected in hemodynamically stable pt, __ is 100% sensitive for AAA | show 🗑
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| show | Acute pericarditis
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| Excessive __ can cause hemorrhagic effusion leading to acute pericarditis | show 🗑
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| show | Acute pericarditis
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| Occurs when the pressure in the pericardial sac exceeds normal RV filling pressure, resulting in restricted filling and decreased cardiac output is | show 🗑
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| show | Malignancy
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| beat to beat variability in the amplitude of the P & R waves unrelated to inspiratory cycle…really only see ~ 20% of time, but is diagnostic of cardiac tamponade if present | show 🗑
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| show | Beck’s triad
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| what is Beck’s triad | show 🗑
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| what is the treatment for cardiac tamponade | show 🗑
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| severe elevation of BP, no evidence of progressive TOD, absence of raised intracranial pressure is what | show 🗑
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| show | Labetalol, clonidine or captopril with outpatient follow up within 72 hrs is recommended
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| show | Gradual (not to the normal range)
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| acute severe elevation in BP, evidence of rapidly progressive TOD is what | show 🗑
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| show | Worsening cerebral, renal or cardiac ischemia
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| hypertensive urgency usually has a BP of >__ | show 🗑
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| hypertensive emergency usually has a BP of > __ | show 🗑
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