36 results
Chest Pain - Diagnosis and Workup Algorithm

History and Exam
Acute life-threatening causes:
 • Acute myocardial infarction
 •
life-threatening causes ... Pneumothorax • Pulmonary ... embolism • Cardiac ... tamponade • Esophageal ... Initial workup: • EKG
EKG in Acute Pulmonary Embolism
The sensitivity and specificity for EKG findings in acute PE are low.
EKG
EKG in Acute Pulmonary ... evaluating for other causes ... of cardio-pulmonary ... #EKG #Pulmonary ... AcutePE #diagnosis #cardiology
Right-Sided Heart Failure - Differential Diagnosis Algorithm
Cardiac Causes - Rule out Left-Sided Heart Failure (Most Common):
Differential Diagnosis Algorithm ... Cardiac Causes ... • Pericardial Tamponade ... Pulmonary Causes ... #HeartFailure #Cardiology
Pulmonary Artery Catheter Pressures
Normal: RA 0-8, RV 15-25/0-8, Mean PAP <25, PCWP 8-12, Cardiac Index 2.6-4.2
HFrEF,
Pulmonary Artery ... 25, PCWP 8-12, Cardiac ... Right-to-Left Shunt Tamponade ... Medicine @ucsdim #PA ... #Hemodynamics #Cardiology
Pericardial Tamponade
Beck's Triad 
1. Hypotension 
2. Jugular venous distension 
3. Muffled heart sounds 
Patient will be
Pericardial Tamponade ... chest pain - PE ... paradoxus - ECG ... #Pericardial #Cardiac ... Triad #Diagnosis #Cardiology
Syncope - Differential Diagnosis Algorithm
Neurocardiogenic:
 • Vasovagal
 • Orthostatic Hypotension
 • Autonomic Neuropathy
 • Situational (micturition,
Differential Diagnosis Algorithm ... Respiratory: • Pulmonary ... Tamponade ... Syndrome #Syncope #Cardiology ... #causes
Chest Pain - Differential Diagnosis Framework

Cardiovascular Causes of Chest Pain:
 • Myocardium:
	- Myocarditis
	- CAD/ACS
	- Valvulopathy
	- Myopericarditis
Cardiovascular Causes ... Pericarditis - Tamponade ... Pulmonary Causes ... • Vasculature: PE ... #Cardiology
Pulse Abnormalities - Differential Diagnosis Algorithm
Unequal/DeIayed:
 • Obstructive arterial disease (ie. Atherosclerosis)
 • Aortic dissection
 •
Differential Diagnosis Algorithm ... pressure >10mmHg: • Cardiac ... tamponade • AECOPD ... Abnormalities #Disorders #Cardiology ... #causes
Cardiac Stress Testing
Exercise:
 • Everyone who can exercise should!
 • They must be able to raise
Cardiac Stress Testing ... production to cause ... arrythmias Diagnostics: EKG ... Nuclear SPECT ($$$), PET ... Stress #Testing #cardiology
Chest Pain / ACS Evaluation Algorithm
Algorithm that attempts to the use history taking (guided by LRs),
Algorithm that ... physical activity - Nausea ... (+LR 2.6) - Cardiac ... - History - EKG ... #cardiology #Angina