Chest Pain
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 27 March 2016
⏱️ 10 minutes
🧾️ Download transcript
Summary
There are six cardiopulmonary causes of chest pain that you need to know.
The SIX Causes
* Cardiac* Acute coronary syndrome (ACS)* Pericarditis with tamponade* Pulmonary* Pneumonia* Pneumothorax* Vascular* Pulmonary embolism* Aortic dissection
Step 1: Core Measures
* Aspirin* EKG
Step 2: Look for the “King” (Acute Coronary Syndrome)
* Four high yield symptoms* Radiation to the RIGHT shoulder* Vomiting* Worsens with exertion* Diaphoresis
Step 3: Look for the “Queen” (Pulmonary Embolism)
* Wells score* PERC rule
Step 4: Print a Previous Cath Report
* Major bonus points with attending!* Other useful information* Previous echocardiograms* Previous stress tests* Previous CTAs for PE
Step 5: Basic Testing Plan
* If concerned for cardiac causes* Troponin* If concerned for pulmonary causes* Chest x-ray* If concerned for vascular causes* CTA of the chest
Additional Reading
* STEMI (EM Clerkship)* Pulmonary Embolism (EM Clerkship)
Transcript
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| 0:00.0 | Hello, med students. This episode has been sponsored by Freed AI. Do you dread the thought of |
| 0:07.1 | endless charting once you become a doctor? Do you think that doctors should be spending more |
| 0:11.9 | time with our patients and less time mindlessly writing notes? Freed AI is the product for you. It is a |
| 0:20.4 | secure, hippocompliant scribe that anybody can use. |
| 0:24.7 | Focus your energy on what matters, providing good patient care. |
| 0:29.5 | Use coupon code EM50 to save 50% the first month you try it, |
| 0:34.1 | and you can cancel at any time if you decide it's not right for you. You can learn more |
| 0:38.9 | at www.gitfreed.a.i. Hello, med students. My name is Zach Olson, and today we are going to address |
| 0:50.5 | one of the core chief complaints. I'm going to give you an approach to chest pain. |
| 0:57.2 | You really need to pay attention today. It's really important, guys. In this episode, there is one |
| 1:02.7 | thing about chest pain that I need you to understand. If you exclude the GI causes of chest pain, |
| 1:10.3 | the most important of those being esophageal rupture, |
| 1:13.9 | there are only six remaining cardiopulmonary causes of chest pain that you need to know, |
| 1:20.2 | because they are life-threatening. |
| 1:22.5 | These are the six can't miss diagnoses. |
| 1:26.1 | There's two cardiac causes, acute coronary syndrome and paracarditis. |
| 1:32.1 | There's two pulmonary causes, pneumonia and pneumothorax. And then there's two vascular causes, |
| 1:40.8 | pulmonary embolism and aortic dissection. And a disclaimer, before we get started, I'm not going to be |
| 1:47.1 | going through O PQRST and telling you to get a thorough medical history and listen to the patient's |
| 1:53.8 | heart and their lungs. I'm not going to be doing any of that in this episode. We are instead going to be |
| 1:59.1 | doing a five-step approach specifically for chest |
| 2:03.1 | pain. These are the five specific things for chest pain that you need to do on every chest pain |
... |
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