Differentials
Myocardial infarction
SIGNS / SYMPTOMS
Presence of typical history of substernal chest pain with associated risk factors, signs, and symptoms.
INVESTIGATIONS
ECG may have ST segment changes that suggest infarction.
Cardiac biomarkers (e.g., cardiac-specific troponins) are typically raised.
Influenza
SIGNS / SYMPTOMS
Myalgia, accompanied by respiratory tract symptoms, fever, and headache.
INVESTIGATIONS
Creatine kinase not elevated unless influenza viral myositis is present. This is very rare and is more likely in children.
Culture, serology, or antigen detection immunoassays may be used, but are not sensitive or specific and need to be interpreted with the clinical findings.
Fibromyalgia
SIGNS / SYMPTOMS
Widespread body pain with areas of focal tenderness at designated points.
Diagnosis made on clinical criteria.
INVESTIGATIONS
Creatine kinase not elevated.
Use of this content is subject to our disclaimer