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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