Approach to chest pain pdf

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Honournyang David. Saunders, Pennsylvania. You must be logged in to post a comment. Skip to content. Figure 1 Figure 2 Questions to Ask Seek information regarding the quality sharp, stabbing vs. Timing of the pain with relationships to exercise, eating, how long the episodes lasts and how often they occur duration and frequency helps determine how serious it is, generally if it is brief, infrequent and resolves completely it is less worrisome.

Ask about any history of trauma. How long has it been going on for? If it has persisted longer than several months, a serious organic etiology is unlikely to be the cause. What makes it better or worse?

In the absence of fever or respiratory symptoms, pain that is worse with inspiration makes the musculoskeletal system more likely.

Are there any constitutional symptoms fever, weight loss, fatigue? Are there any respiratory symptoms e. Are there any cardiac symptoms e. What do they think is causing the pain? Any recent stressors at home or school or problems with anxiety? Cardiac vs. Strains and costochondritis result from overuse. Strains usually involve the major muscle groups of the chest while costochondritis affects one or more of the rib cartilages. Precordial catch syndrome causes a sharp, well-localized pain occurring at rest.

Typically it lasts seconds to minutes and is aggravated by deep breathing and relieved somewhat by sitting up straight and the physical exam is normal. The slipping rib syndrome involves the eighth, ninth, and tenth ribs which are joined together by fibrous tissue. Laxity of the fibrous tissue can cause these ribs to slip over one another.