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Medgeeks with Andrew Reid

PA Boards 02: Chest Pain

Medgeeks with Andrew Reid

Medgeeks

Education, Medicine, Health & Fitness

4.8997 Ratings

🗓️ 31 October 2013

⏱️ 23 minutes

🧾️ Download transcript

Summary

In this session, I review a general apprach to the person complaining of chest pain.  Before you can say this patient, has a benign etiology, you must first rule out the dangerous causes of chest pain.

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Transcript

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0:00.0

What's up guys and welcome to the second episode of the Physician

0:03.8

assistant boards.com podcast and today we're going to talk about chest pain.

0:08.8

So chest pain is one of those symptoms that can be very scary. I know we're taught in school

0:14.6

to think of chest pain of something that's very life-threatening. However, the

0:18.2

majority of the time these are actually very benign causes of chest pain.

0:23.6

And a lot of times, there really, in fact,

0:25.6

is no chest pain.

0:27.7

So just to give you an example,

0:29.1

the University of Michigan did a study over a one-year period,

0:32.1

and this was done in a family practice setting.

0:34.9

They had 399 patients reviewed for the complaint of chest pain.

0:40.0

What they found was 20% of all the diagnosis were musculoskeletal, followed by

0:47.8

reflux, which was at 13%, and costochondritis was at 13.1%.

0:55.0

Stable Angina was the diagnosis only 10% of the time in these chest pain patients.

1:04.0

Unstable or possible MIs, so ACS, was only present in about one or one and a half percent of these patients.

1:12.0

Now, this means that half percent of these patients.

1:12.6

Now, this means that 60% of the patients

1:15.4

actually had no organic cause whatsoever.

1:17.8

So that means they really had no idea

1:20.2

or really couldn't identify the cause of the chest pain.

1:25.0

Now clearly, you know, as the older the person gets, the more likely there really is to be some type of coronary artery disease or some type of

1:34.0

eschemia as a cause of chest pain. But I want you to know

...

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