Topic Info - BotMed Application

TopicName

Chest pain

ClinicalTests

Troponin (MI); 
D-dimer (PE); 
CBC (WBC, anemia); 
ESR/CRP (inflammatory process); 
LFTs (biliary colic, referral pain); 
Lipase, amylase(pancreatitis); 
BNP(CHF); 
Coagulation study: INR, PTT (may be necessary for surgery);
Blood culture, sputum culture(infections).

ImagingStudies

ECG (MI check)
x-Ray of the chest (pulmonary edema)
Duplex US of the extremities (vein thrombosis)
CT chest with contrast (pulmonary effusion; pneumonia; pulmonary abscess, aortic dissection)

PhysicalExams

Vital signs ± BP in both arms; complete cardiovascular exam (JVD, PMI, chest wall tenderness, heart sounds, pulses, edema); lung and abdominal exams; lower extremity exam (inspection for signs of DVT).

Comment

R/O: 
Cardio: MI; Pericarditis;
Vascular: Aortic dissection; PE;
Pulmonary: Lung Cancer; Pneumonia; Pneumothorax; Foreign body; 
GI: Gastric cancer; Esophageal cancer,
MSK: Herpes zoster; 
Psycho; Panic attack; 

Location, quality, severity, radiation, duration, context (exertional, postprandial, positional, cocaine use, trauma);
associated symptoms (sweating, nausea, dyspnea, palpitations, sense of doom, fever); 
exacerbating and alleviating factors (especially medications); 
history of similar symptoms; known heart or lung disease or history of diagnostic testing; cardiac risk factors (hypertension, hyperlipidemia, smoking, family history of early MI); 
pulmonary embolism risk factors (history of DVT, coagulopathy, malignancy, recent immobilization).

WebLink

https://www.aafp.org/afp/2005/1115/p2012.html | https://www.aafp.org/afp/2013/0201/p177.html