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Chest pain

  • Common ddx

    • precordial catch syndrome, costochondritis, valvular disease, GERD, candidiasis, rib fracture, shingles, panic attack, asthma attack, COPD exacerbation
  • Serious ddx

    • angina, pneumonia, PE, MI, aortic dissection, tamponade, pericarditis, CHF, pneumothorax, lung cancer, TB
  • Orders, labs

    • EKG, old EKGs
    • cardiac monitor
    • CXR
    • CBC, BMP, BNP
    • coags
    • cardiac enzymes
    • Utox if cocaine
    • ASA, NTG
  • Other ddx

    • breast issue, Dressler's, HCM, variant angina, cocaine, pleural effusion, ILD, gallstone, hiatal hernia
  • HPI

    • onset: acute vs chronic, new vs old
    • location: substernal
    • quality: pressure, sharp, radiation
    • quantity
    • alleviation: rest, bending forward, antacids, NTG
    • aggravation: breathing, exertion, positional
    • duration
    • pain currently
    • who's your cardiologist, PCP
  • ROS

    • fever, diaphoresis
    • rash
    • palpitations, dyspnea, orthopnea, PND
    • cough, sputum, hemoptysis
    • abdominal pain, nausea, vomiting, dysphagia
    • syncope
    • lower extremity pain
  • PMH

    • CAD, MI, recent MI, PE, DVT, asthma, COPD, anxiety disorder
  • FH

    • CAD
  • SH

    • smoker, cocaine, stasis, recent travel
  • Meds

    • anticoagulants, ED drugs
  • Allergies

  • Px

    • vitals
    • gen impression
    • skin: rash
    • JVD
    • cardio: murmurs, gallops, friction rub
    • pulm: crackles, unequal breath sounds
    • GI: upper abdominal tenderness
    • MSK: tenderness with palpation
    • breast: mass, lesions
    • extremities: bilateral pulse, edema

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.