Assessment of chest pain

Images

Assessment of chest pain

Distribution of final diagnoses in people over 35 years admitted to hospital from one US hospital emergency department with chief complaint of non-traumatic chest pain, over a 5-year period (PE, pulmonary embolism)

Created by BMJ; based on data from Kohn MA, Kwan E, Gupta M, et al. Prevalence of acute myocardial infarction and other serious diagnoses in patients presenting to an urban emergency department with chest pain. J Emerg Med. 2005 Nov;29(4):383-90

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• Aetiology

Assessment of chest pain

Composition of the HEART score for chest pain patients in the emergency department

Six AJ, et al. Neth Heart J. 2008;16:191-6; used with permission

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• Diagnosis Approach

Assessment of chest pain

Spiral computed tomography pulmonary angiogram showing a large filling defect within the pulmonary vasculature compatible with a saddle embolus

From the collection of Professor James Brown; used with permission

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• Differentials

Assessment of chest pain

Varicella zoster virus

Courtesy of Daniel Eisen, MD; used with permission

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• Diagnosis Approach

Assessment of chest pain

ECG showing changes of an acute inferior myocardial infarction with ST elevation in leads II, III, and aVF

From the collection of Professor James Brown; used with permission

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• Diagnosis Approach
• Differentials

Assessment of chest pain

ECG showing ST depression

From the personal collection of Dr Syed W. Yusuf and Dr Iyad N. Daher, Department of Cardiology, University of Texas, Houston, TX; used with permission

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• Diagnosis Approach

Assessment of chest pain

Angiogram showing occluded right artery

From the personal collection of Dr Mahi Ashwath; used with permission

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• Diagnosis Approach

Assessment of chest pain

Chest x-ray showing a widened mediastinum

From the collection of Professor James Brown; used with permission

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• Diagnosis Approach
• Differentials

Assessment of chest pain

Chest x-ray showing a large globular heart in a patient with pericardial tamponade

From the collection of Professor James Brown; used with permission

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• Diagnosis Approach
• Differentials

Videos

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  Needle decompression of tension pneumothorax animated demonstration

  How to decompress a tension pneumothorax. Demonstrates insertion of a large-bore intravenous cannula into the fourth intercostal space in an adult.

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  Venepuncture and phlebotomy animated demonstration

  How to take a venous blood sample from the antecubital fossa using a vacuum needle.

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  How to perform an ECG animated demonstration

  How to record an ECG. Demonstrates placement of chest and limb electrodes.