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13 terms

Clinical Presentations

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Pulmonary Embolism
Sudden onset of unilateral chest pain
Worse on inspiration
Pain accompanied by breathlessness (dyspnoea) and coughing up blood (haemoptysis)
Sinus Tach Obstructive shock, hypotension
Pericarditis
Central chest pain worse on inspiration
Relieved by sitting forward
Pericarditis friction rub
Stable angina- narrowing of coronary artery
Chest pain on exercise
Crushing, squeezing sensation, radiates to the jaw, neck and left arm
Unstable angina- partial occlusion of coronary artery
Chest pain at rest
Presented as cold and sweaty (Sympathetic NS)
ECG: T wave inversion
MI- myocardial necrosis
Pain radiates to neck, shoulders and arm
Requires intravenous opioids (diamorphine)
Unrelieved by GTN
Raised serum biomarkers
Aortic dissection
Severe tearing, ripping pain that radiates through the back between the shoulder blades
Cardiogenic
Severe reduction in cardiac contractility
Raised CVP, low CO
Obstructive
Mechanical obstruction to cardiac output - pulmonary embolus
Increased afterload
Hypovolemic
Cause: Haemorrage, burns, diarrhoea, excessive diureses
decreased circulating bloodd volume
decreased CO CVP
Distributive (septic)
Increased vascular capacitance
Decreased central venous pressure
Allergens, bacterial toxins
Septic shock
Type of distributive shock
Gram +ve: Staph Aureus exotoxin TSS
Gram -ve: LPS endotoxin SIRS
Toxic Shock syndrome
Macular rash, fever desquamation, hypotension
Secondary Hypertension
BP> 120/80 mmHg
Renal problems
Endocrine Dysfunction: Conns, Hyperthyroidism, Acromegaly, Phaeocromocytoma, Cushings syndrome
Coarctation of Aorta
Ionotropic: NSAID, hormones