Differential Diagnosis of Chest Pain

Differential Diagnosis of Chest Pain includes

1. Cardiac
a. Coronary artery disease (supported by ECG abnormalities-changes in the T waves, ST segments, or conduction pattern; not ruled out by a normal ECG), coronary artery embolism or dissection, coronary artery abnormalies.

Differential Diagnosis of Causes of Angina Besides Coronary Artery Disease

There are othe cardiac causes of angina besides coronary artery disease:

A. Congenital anomalies of the coronary arteries can take many forms. Their prevalence is 1% to 2% of the general population. Anomalous origin of the left or right coronary artery from the contralateral sinus of valsava with passage between the aorta and pulmonary artery may produce ischemia and is associated with sudden death.

Stable Angina

           Chronic Stable Angina is the initial manifestations of Ischemic Heart Disease in approximately half of patients with Coronary Artery Disease, Approxymately 15 millions American have CAD. Despite the well-documented decline in cardiovascular mortality, Ischemic Heart Disease remains the leading single cause of death in The United States and is reponsible for nearly one of every five deaths.

Late Complications of Myocardial Infarction

           Postinfarction complication rates have fallen dramatically since the advent of early reperfusion strategies. Nevertherles, many patients (large infarction, silent infarction, late presentation, delayed or incomplete reperfusion) remain at high-risk for life-threatening late complications of myocardial infarction. The role of an urgent beside echocardiogram for a rapid diagnosis cannot be overemphasized. The mnemonic "FEAR A MI" is a logical way to remember and respect these potentially life-threatening complication while caring for a patient in the ICU, as demontrated below:

Symptomatic Tachycardia in Cardiovascular Emergencies

      Patients who are pulseless or clinically unsable with the tachycardia require immediet defibrillation  with unsynchronized high-energy shocks (200, 300, 360 Joule) followed by appropriate ABC attention of ACLS. The cardiac rhythm is briefly assessed between shocks.

Symptomatic Bradycardia in Cardiovascular Emergencies

          Bradycardia in Cardiovascular Emergencies is when heart rate < 60 beats per minute and inadequate for clinical condition. So what would you do as a Doctor or paramedic to treat this condition? There are step which must done: SSSSSlow

Cardiac Tamponade

Cardiac tamponade occurs with an increase in intrapericardial pressure due to a pericardial effusion, which is characterized by

               1. Elevation of intrapericardial pressure

               2. Limitation of Right Ventricle Diastolic Filling

               3. Reduction of Stroke Volume and Cardiac Output.

The presence of a pericardial effusion does not necessarily mean tamponade physiology is present.