Alexandra Ward, MD, FACC Profile picture
Jul 14, 2018 • 10 tweets • 7 min read Twitter logo Read on Twitter
1/10 What is chest pain? #FITSurvivalGuide #Tweetorial
- "Pain anywhere in the chest" 🤦‍♀️
- Many things cause chest pain
- ❤️ vs ❌❤️
- ❤️ - ischemic vs non ischemic
- Life threatening vs not
2/10 - Common causes of chest pain (by system) #FITSurvivalGuide
- Cardiac
- Pulmonary
- GI
- MSK
- Infectious
- Psych
- Skin/ soft tissue
3/10 Chest pain- The History! #FITSurvivalGuide
- Going back to medical school 👩‍⚕️👨‍⚕️🥼😷
- The key to figuring out what type of chest pain the patient has!
- Quality, location, radiation, duration, associated symptoms, relieving factors!
4/10 ❤️ Chest pain #FITSurvivalGuide
- Typical vs atypical symptoms
- Again history is 🗝️
- Pain/pressure/tightness
- Some patients will deny chest pain, but endorse pressure
- If prior history of cardiac disease, ask if the symptoms are similar!
5/10 Risk Factors for ❤️ chest pain #FITSurvivalGuide
- ⬆️ age
- Male sex
- FH
- 🚬
- HTN
- HL
- Obesity
- DM
6/10 ❤️ Chest pain - Women #FITSurvivalGuide
- Often present with atypical symptoms
- Have a high index of suspicion
- Not just anxious!!
- Microvascular angina, MINOCA
7/10 ❤️ Non Ischemic #FITSurvivalGuide
- Pericarditis
- Myocarditis
- Heart Failure
- Stress CM
- MV Disease
8/10 Can't miss chest pain etiologies!! #FITSurvivalGuide
- Aortic Dissection
- PTX
- PE
- Tamponade
- Esophageal Rupture
9/10 ❌❤️ Chest Pain #FITSurvivalGuide
- Ask about duration/character of pain
- History is 🗝️🔑!!
- Focus on - duration, character, associated symptoms
- Not all chest pain is ❤️!
10/10 Chest pain work up! #FITSurvivalGuide
- EKG (of course!)
- CXR
- Biomarkers (only if indicated!)
- CTA (PE/dissection)
- ECHO (if indicated)

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