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)