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Chest Pain - Diagnosis and Workup Algorithm

History and Exam
Acute life-threatening causes:
 • Acute myocardial infarction
 •
Chest Pain - Diagnosis ... infarction • Aortic ... Pulmonary embolism • Cardiac ... EKG • Bedside ultrasound ... Matthew Ho, MD PhD
Atrial Fibrillation Overview

Symptoms:
Palpitations, light-headedness, dizziness, dyspnea, exercise intolerance, chest pain, near-syncope, syncope.

1. Why?
Cardiac:
• Valvular heart disease
•
exercise intolerance, chest ... pain, near-syncope ... Cardiac: • Valvular ... #Fibrillation #Cardiology ... #Management #Algorithm
This is a parasternal long axis view of a young patient presenting with 3 days of
He had no chest ... pain, a normal chest ... Beside ultrasound ... root, and left atrium ... #POCUS #CardiacUS
Atrial Fibrillation (A-Fib) Summary

Symptoms:
• Palpitations, light-headedness, dizziness, dyspnea, exercise intolerance, chest pain, near-syncope, syncope.

Why?
Cardiac:
	• Valvular heart
exercise intolerance, chest ... pain, near-syncope ... Cardiac: • Valvular ... Moderate or severe mitral ... diagnosis #management #cardiology
Palpitations - Differential Diagnosis Framework

What?
• It is an unpleasant awareness or sensation that the heart is
flip-flopping in the chest ... heart failure • Mitral ... disease (e.g., aortic ... pain: Underlying ... #Palpitations #Cardiology
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
JVD, Orthopnea/PND ... importantly, bedside ultrasound ... #differential #algorithm ... #management #cardiology ... #heartfailure #chf
Preoperative Risk Evaluation

Major Pre-Op Questions:
1. Does the patient have any modifiable risk factors that could be
disease b) CHF ... event, follow ACC algorithm ... risk (>5%): - Aortic ... one post op Cardiology ... change CV risk Chest