Abstract
Chest pain is one of the most commonly encountered clinical presentations in the inpatient setting. Given the broad differential diagnosis of chest discomfort, the initial evaluation can be challenging. Life-threatening conditions such as acute myocardial infarction, aortic dissection, pulmonary embolism, and tension pneumothorax need to be recognized promptly in order to prevent major morbidity and mortality. A thorough history and physical examination can often limit unnecessary testing, particularly in patients who are at a low risk for serious cardiovascular disease. Identifying characteristic features of the pain such as its onset, duration, character, and possible triggers and alleviating factors can help narrow the differential diagnosis and guide further diagnostic testing. In addition, all patients with new onset chest pain should receive an electrocardiogram and a chest X-ray as part of a rapid initial assessment. This chapter describes the main causes of chest pain and helps guide the initial evaluation based on history, physical examination, and initial testing.
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Abbreviations
- ACS:
-
Acute coronary syndrome
- CAD:
-
Coronary artery disease
- CTA:
-
Computed tomography angiogram
- CXR:
-
Chest X-ray
- ECG:
-
Electrocardiogram
- MI:
-
Myocardial infarction
- NSTEMI:
-
Non-ST-elevation myocardial infarction
- NTG:
-
Nitroglycerin
- PE:
-
Pulmonary embolism
- PTX:
-
Pneumothorax
- STEMI:
-
ST-elevation myocardial infarction
- TTE:
-
Transthoracic echocardiogram
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Korjian, S., Gibson, C.M. (2020). Chest Pain. In: Wells, B., Quintero, P., Southmayd, G. (eds) Handbook of Inpatient Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-47868-1_24
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DOI: https://doi.org/10.1007/978-3-030-47868-1_24
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