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There are six cardiopulmonary causes of chest pain that you need to know.
The SIX Causes
- Cardiac
- Acute coronary syndrome (ACS)
- Pericarditis with tamponade
- Pulmonary
- Pneumonia
- Pneumothorax
- Vascular
- Pulmonary embolism
- Aortic dissection
Step 1: Core Measures
- Aspirin
- EKG
Step 2: Look for the “King” (Acute Coronary Syndrome)
- Four high yield symptoms
- Radiation to the RIGHT shoulder
- Vomiting
- Worsens with exertion
- Diaphoresis
Step 3: Look for the “Queen” (Pulmonary Embolism)
- Wells score
- PERC rule
Step 4: Print a Previous Cath Report
- Major bonus points with attending!
- Other useful information
- Previous echocardiograms
- Previous stress tests
- Previous CTAs for PE
Step 5: Basic Testing Plan
- If concerned for cardiac causes
- Troponin
- If concerned for pulmonary causes
- Chest x-ray
- If concerned for vascular causes
- CTA of the chest
Additional Reading
- STEMI (EM Clerkship)
- Pulmonary Embolism (EM Clerkship)