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Table: Clinical and Diagnostic Features of Chest Pain

This table summarizes the key clinical features, physical exam findings, electrocardiogram results, and chest x-ray findings for different conditions that can cause chest pain. Stable angina presents with substernal pressure or tightness after exertion relieved by rest, with possible murmurs or S4 on exam and ST depression or T-wave changes on ECG. Unstable angina is similar but can occur at rest. Myocardial infarction causes pressure or tightness lasting over 30 minutes, possibly with murmurs, S3, or signs of heart failure on exam and ST elevations on ECG. Pericarditis causes sharp pleuritic pain relieved by sitting up with pericardial rub and ST elev

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146 views2 pages

Table: Clinical and Diagnostic Features of Chest Pain

This table summarizes the key clinical features, physical exam findings, electrocardiogram results, and chest x-ray findings for different conditions that can cause chest pain. Stable angina presents with substernal pressure or tightness after exertion relieved by rest, with possible murmurs or S4 on exam and ST depression or T-wave changes on ECG. Unstable angina is similar but can occur at rest. Myocardial infarction causes pressure or tightness lasting over 30 minutes, possibly with murmurs, S3, or signs of heart failure on exam and ST elevations on ECG. Pericarditis causes sharp pleuritic pain relieved by sitting up with pericardial rub and ST elev

Uploaded by

drng48
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Table : Clinical and diagnostic features of chest pain

Condition Pain features Physical examination Electrocardiogram Chest x-ray


Stable angina Substernal pressure, tightness, ache, Normal or S4, murmur may be ST depression, T-wave May be normal
heaviness after exertion, lasting 10 present abnormalities
minutes or more, relieved by rest
Unstable angina Substernal pressure or tightness at rest Normal or S4, murmur may be ST depression, T-wave May be normal
lasting 10 to 20 minutes occasionally present abnormalities
relieved by nitroglycerin
Myocardial Substernal pressure or tightness with Normal or S4, murmur may be ST elevations in contiguous May be normal unless
infarction radiation to left or both arms or neck, present, S3 if congestive heart leads with reciprocal changes congestive heart failure is
lasting >30 minutes failure present present
Pericarditis Sharp, pleuritic, in the left precordial area, Pericardial rub Diffuse ST elevations
may last hours or days, relieved by sitting
upright
Aortic dissection Abrupt onset of severe tearing pain Blood pressure differential upper LVH may be present Widened mediastinum
radiating to the back extremities, murmur of aortic
insufficiency
Anxiety/panic Sharp, stabbing, variable length Normal cardiovascular exam Normal Normal
attacks
Pneumonia Sharp, sudden onset accompanied by Crackles, egophony Normal Evidence of consolidation
fever, dyspnea
Pulmonary Abrupt onset, accompanied by dyspnea Right ventricle heave, tachycardia, Tachycardia, RVH, RAD May be normal, atelectasis
embolism right-sided S3
Costochondritis Sharp pain, lasting seconds or hours, Chest tenderness may be present Normal Often normal
worsened by palpation or movement
Pneumothorax Abrupt onset, accompanied by dyspnea Absent breath sounds on the Tachycardia Collapsed lung
affected side, hyper resonant to
percussion
GERD Burning or epigastric pain, relieved by Normal Normal Normal
antacids or proton pump inhibitors

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