Discussion Question: Chest pain
Discussion Question: Chest pain
Vascular: Heart failure. Have you experienced shortness of breath with exertion that is alleviated by rest? (Harskamp et al., 2019).
Infection: Community-Acquired Pneumonia (CAP). A chest radiograph is obtained in patients suspected of having CAP to rule out conditions that mimic CAP and confirm the presence of an infiltrate that aligns with the presentation of CAP.
Neoplasm: Lung cancer. Chest X-Ray is the initial test that can be used when suspecting a patient has malignancy. It helps to visualize any abnormalities on the chest before progressing to more advanced imaging tests (Harskamp et al., 2019).
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Drugs: Drug-induced chest pain. Are you taking any medications associated with side effects of inducing chest pain?
Inflammatory/Idiopathic: Pericarditis. Have you experienced new-onset chest pain that worsens with inspiration or when reclining and is alleviated by leaning forward?
Congenital: Congenital cardiomyopathy. An Electrocardiogram (ECG) can confirm or rule out Congenital cardiomyopathy since it records the heart’s electrical signals and shows how fast or slow the heart is beating. The ECG can help to identify if a patient has arrhythmias (Brenna et al., 2020).
Autoimmune: Autoimmune myocarditis. A complete blood count (CBC) can be used to establish a patient’s Lymphocyte, Eosinophil, and Neutrophil count, which helps confirm or rule out Autoimmune myocarditis (Brenna et al., 2020).
Trauma: Blunt chest trauma. Have you experienced any direct or indirect trauma, especially to your chest?
Endocrine/Metabolic: Hyperthyroidism. Thyroid function tests can rule out hyperthyroidism, including Thyroid-stimulating hormone, Free thyroxine (FT4), and Total triiodothyronine (T3). Hyperthyroidism is characterized by reduced TSH levels and increased T3 and T4 levels.
Social/Psych: Panic Disorder. Do you experience periods of intense anxiety accompanied by shortness of breath and chest pain? (Harskamp et al., 2019).
References
Brenna, C., Afgani, F. J., Hanneman, K., Levitan, D., Udell, J. A., Sacha Bhatia, R., Harvey, P. J., & Nguyen, E. T. (2020). Chest pain investigation in patients at low or intermediate risk: What is the best first-line test to rule out coronary artery disease?. Canadian Family Physician, 66(1), 24–30.
Harskamp, R. E., Laeven, S. C., Himmelreich, J. C., Lucassen, W., & van Weert, H. (2019). Chest pain in general practice: a systematic review of prediction rules. BMJ Open, 9(2), e027081. https://doi.org/10.1136/bmjopen-2018-027081
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