Chest Pain Diagnosis and Management Algorithm STEMI: - Hx: Pressure like CP, Radiation to arm/jaw, CAD risk factors - PEX: Non-reproducible, Non-pleuritic, N/V/diaphoresis Aortic Dissection: - Hx: Sudden onset, severe, tearing CP, Risks: h/o Marfan, HTN, cocaine - PEX: New murmur, Pulse deficit, Focal neuro deficit, Limb ischemia Pulmonary Embolism: - Hx: Sudden onset pleuritic CP, Dyspnea, PE risk factors - PEX: Dyspnea, Leg pain/swelling, Wells score Pericarditis: - Hx: Pleuritic pain, Preceded by URI, underlying dz (SLE, uremia) - PEX: Positional: worse supine, improves on sitting up, Pericardial friction rub, Fever, ↑WBC Boerhaave's: - Hx: Severe vomiting retrosternal CP, H/O recent instrumentation, EtOH, blunt trauma, caustic ingestion, HIV - PEX: crepitus? Pneumothorax: - Hx: Acute pleuritic pain, Asthenic body, h/o trauma - PEX: Decreased/absent breath sounds, Dyspnea, H/O COPD, asthma, CF, PCP #ChestPain #Diagnosis #Management #Algorithm #differential
