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Chest Pain - Differential Diagnosis Framework

Cardiovascular Causes of Chest Pain:
 • Myocardium:
	- Myocarditis
	- CAD/ACS
	- Valvulopathy
	- Myopericarditis
Myopericarditis • Vascular ... : - Aortic dissection ... - Tamponade Pulmonary ... Pleuritis • Alveoli ... : - CHF - Pneumonia
Stage I - Redistribution
In a normal chest film with the patient standing erect, the pulmonary vessels
The pulmonary vascular ... In daily clinical ... during a period of CHF ... #Clinical #Radiology ... #CXR #CHF #Cephalization
On the left another patient with alveolar edema at admission, which resolved after treatment.
When you scroll
another patient with alveolar ... difference in vascular ... #Clinical #Radiology ... #CXR #CHF #Alveolar ... #Pulmonary #Edema
Stage III - Alveolar edema
This stage is characterized by continued fluid leakage into the interstitium, which
left decubitus position ... increased width of the vascular ... #Clinical #Radiology ... #CXR #CHF #Alveolar ... #Pulmonary #Edema
Heart failure with Reduced Ejection Fraction (HFrEF)
Clinical Presentation
1. Typical symptoms: dyspnea, orthopnea paroxysmal noctumal dyspnea, fatigue,
Fraction (HFrEF) Clinical ... venous pressure, positive ... 0.25), murmur of valvular ... Kerley B lines, alveolar ... → no signs of CXR
Preoperative Risk Evaluation

Major Pre-Op Questions:
1. Does the patient have any modifiable risk factors that could be
murmur 3/6) - Pulmonary ... disease b) CHF ... event, follow ACC algorithm ... Change in clinical ... risk (>5%): - Aortic
Peripartum Cardiomyopathy (PPCM)

What is PPCM?
• A form of acute systolic heart failure that develops late in
Cesarean delivery Clinical ... Key Point: High clinical ... Relaxin: reduces vascular ... heart failure • Aortic ... congestion on a CXR
Authors: Mark M. Ramzy, DO, EMT-P (@MarkRamzyDO, EM Resident Physician, Drexel University, Department of Emergency Medicine)
Pertinent positives ... structural and vascular ... a chest x-ray (CXR ... Most commonly caused ... #Radiology #CTChest