Chest Pain

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1.

1/3 of these patients have normal coronary arteries Accompanied by N&V, diaphoresis, and SOB Acute onset of pain, SOB, decreased breath sounds, and subtle edge on CXR Acute onset of severe, tearing pain Angina at rest due to unstable plaque or vasoconstriction Aortic regurg murmur Associated with anterior MIs Associated with inferior MIs Beck's Triad Burning pain with acid taste Can lead to mediastinitis Cardiac risk factors

Variant/Prinzmetal angina Acute MI Pneumothorax

23.

Don't use this drug with RV infarction Due to inadequate perfusion of the myocardium EKG findings for RV infarction Exertional and relieved with sublingual NTG Friction rub Improves GERD/dyspepsia Inverted T wave in lead 3 Lavigne's sign Location of HZ (shingles) Main utility of EKG May be worse after meals May present with pain before a rash develops Med that relaxes smooth muscle MEDICAL EMERGENCY Platelet response to a rupture Pneumonia: gradual or acute onset of pain? Positional or pleuritic chest pain PR depressions Prodrome that women often present with for one month prior to MI Q wave in lead 3 Reduces LV dysfunction RUQ pain Sinus tachycardia on EKG with evidence of right heart strain Sites where fibrinogen connects and allow platelets to aggregate ST elevations

NTG Unstable angina ST elevation in V4 on right-sided EKG Stable angina Pericarditis Antacids / GI cocktails Pulmonary embolus Clutching chest Thoracic Detect MI GERD/dyspepsia HZ (shingles) NTG Esophageal Rupture (Boorhave's syndrome) Adhesion, activation, aggregation Gradual Pericardial Tamponade Pericarditis Fatigue, difficulty sleeping, SOB Pulmonary embolus ACE-I Cholecystitis Pulmonary embolus Glycoprotein IIb/IIIa receptors STEMI, Variant/Prinzmetal angina, Pericarditis Unstable angina Abdominal pain, N&V

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Aortic dissection
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Unstable angina

28. 29.

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Proximal aortic dissection Mobitz Type II, complete heart block Bradycardia, first-degree AV blocks, Mobitz Type I Pericardial Tamponade GERD/dyspepsia

30. 31. 32.

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33. 34.

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Esophageal Rupture (Boorhave's syndrome) DASH SHTS - DM, Age > 40, Sex, HTN, Smoker, Hypercholesterolemia, Truncal obesity, Sedentary lifestyle Plaque rupture and thrombosis, vasoconstriction Unstable angina, Variant/Prinzmetal angina Variant/Prinzmetal angina Hypotension, JVD, Distant/muffled heart sounds Pericarditis

36.

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37.

38.

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Cause of stable angina Chest pain at rest Chest pain at rest due to vessel spasm Components of Beck's Triad Constant retrosternal pain that is worse with lying flat and relieved by sitting forward Decreased distal pulses or neurologic findings Decreases heart's oxygen demand Decreases mortality Don't give this drug with CHF or PVD Don't use this drug with inferior MI

39.

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40. 41.

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42. 43. 44. 45.

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Distal aortic dissection BB ASA, ACE-I, BB, NTG BB Morphine

46.

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47.

20. 21.

48.

State between stable angina and MI Symptoms with inferior MI

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50. 51. 52. 53. 54. 55. 56. 57. 58.

T wave inversions Tachycardia Treatment for anxiety attack Two components of Acute Coronary Syndrome Two most frequently missed MIs Vasodilatory What drug should you give for CHF? What should you not give to a pt who uses cocaine? When is oxygen not needed?

Pericarditis, Pulmonary Embolus Pericardial Tamponade SSRIs, NERIs Unstable angina, MI Posterior, high lateral NTG, CCB ACE-I Beta Blocker Not hypoxic, admitted, pain-free