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Chest pain Seminar

Chest pain Seminar. Prepared by | Abdullah A. Laftal Group 32 | Medicine 3. Objectives :. define chest pain . state the causes , prevalence management of patient with chest pain. Chest pain :.

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Chest pain Seminar

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  1. Chest pain Seminar Prepared by | Abdullah A. Laftal Group 32 | Medicine 3

  2. Objectives : • define chest pain . • state the causes , prevalence • management of patient with chest pain

  3. Chest pain : • symptom of a number of serious conditions and is generally considered a medical emergency. Even though it may be determined that the pain is non-cardiac in origin, this is often a diagnosis of exclusion made after ruling out more serious causes of the pain

  4. Case 1 : • A 53-year-old man was admitted to the hospital . • The patient had been well until three months earlier, when hebegan to have increasingly severe exertionaldyspnea, withoutchest pain.

  5. On the day of admission, he had been at work, liftingand transporting heavy objects, when a sensation of "heaviness"developed across his chest, accompanied by dyspnea. • In an ambulanceen route to this hospital, ventricular fibrillation was discovered,and a single shock resulted in reversion to a normal rhythm.

  6. An electrocardiogram obtained at the time of his arrival atthis hospital showed elevated ST segments in leads V1 throughV4, with depressed ST segments in leads II and III • The patient had a 40-pack-year history of cigarette smoking;he drank little alcohol. He had hypertension and hyperlipidemiaand took medications for both. There was no history of diabetesmellitus or previous chest pain and nofamily history of coronarydisease.

  7. On physical examination : • Temperature was 38.3°C • pulse was 85 • blood pressure was 115/80 mm Hg. • The patientwas alert and comfortable. • The jugular venous pressure was 8cm of water. • Bibasalcrackles were present. • A grade 1 systolicmurmur was heard, with a third heart sound. • The abdomen wasnormal • and there was no peripheral edema.

  8. Management: Oxygen, lidocaine, aspirin, and metoprolol were administered, the patient was transported urgently to the cardiac catheterizationunit. A coronary angiographic study revealed three-vessel disease,including complete occlusion of the left anterior descendingartery at its ostium. A stent was placed

  9. DDx : Pulmonary pneumonia pulmonary embolism (PE)* pneumothorax/hemothorax* empyema pulmonary neoplasm bronchiectasis TB

  10. Cardiac MI angina* myocarditis Pericarditis cardiac tamponade*

  11. Gastrointestinal Esophageal spasm, GERD, esophagitis, ulceration, achalasia, neoplasm PUD gastritis pancreatitis biliary colic

  12. mediastinallymphoma Thymoma vascular aortic aneurysm surface structures costochondritis rib fracture skin (bruising, shingles) breast

  13. Chest pain :

  14. An infiltrate in the medial segment of the right middle lobe will obscure the right heart border on the frontal view, on the lateral view, is seen as a triangular density radiating from the hilum toward the anterior and lower part of the chest

  15. Group 32 medical student send the gratitude and thanks to Dr.Abdullah AssiriDr.Mohammad Younis Khanfor their support .Also to the organizing committee of SHA 21 scientific session for encourage young researchers

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