Chest Pain

There are six cardiopulmonary causes of chest pain that you need to know.



The SIX Causes



* Cardiac* Acute coronary syndrome (ACS)* Pericarditis with tamponade* Pulmonary* Pneumonia* Pneumothorax* Vascular* Pulmonary embolism* Aortic dissection



Step 1: Core Measures



* Aspirin* EKG



Step 2: Look for the “King” (Acute Coronary Syndrome)



* Four high yield symptoms* Radiation to the RIGHT shoulder* Vomiting* Worsens with exertion* Diaphoresis



Step 3: Look for the “Queen” (Pulmonary Embolism)



* Wells score* PERC rule



Step 4: Print a Previous Cath Report



* Major bonus points with attending!* Other useful information* Previous echocardiograms* Previous stress tests* Previous CTAs for PE



Step 5: Basic Testing Plan



* If concerned for cardiac causes* Troponin* If concerned for pulmonary causes* Chest x-ray* If concerned for vascular causes* CTA of the chest



Additional Reading



* STEMI (EM Clerkship)* Pulmonary Embolism (EM Clerkship)