Cardiac issues

Angina

• What it is: Chest pain due to temporary reduced blood flow to the heart.

• Causes: Often from coronary artery disease, exertion, or stress.

• Signs: Pressure or squeezing in chest, often relieved by rest/nitro, may radiate to arm, neck, jaw.

• Scenario: A 58-year-old male presents with chest discomfort after climbing stairs; he feels better after resting.

Myocardial infarction (heart attack)

• What it is: Death of heart muscle due to prolonged lack of blood flow.

• Causes: Blocked coronary artery (often from a clot).

• Signs: Severe, crushing chest pain, radiates to arm/jaw, nausea, diaphoresis, lasts >20 min.

• Scenario: A 65-year-old female with diabetes presents with chest pain, nausea, and sweating after eating lunch.

Aortic Aneurysm

• What it is: Abnormal bulge in the aorta wall.

• Causes: Weakness in vessel wall, hypertension, atherosclerosis.

• Signs: Sudden, severe chest/abdominal pain, pulsating mass, shock if ruptured.

• Scenario: A 72-year-old male presents with sudden, tearing chest pain, feels weak.

Congested Heart Failure

• What it is: Heart can’t pump effectively, leading to fluid buildup.

• Causes: Long-term HTN, CAD, valve disease.

• Signs: Dyspnea, orthopnea, edema, fatigue, elevated JVP.

• Scenario: A 70-year-old female with a history of HTN presents with swelling in her ankles, shortness of breath.

Pericarditis

• What it is: Inflammation of the pericardium (heart sac).

• Causes: Viral infection, post-MI, autoimmune.

• Signs: Sharp, pleuritic chest pain, relieved by sitting forward, fever.

• Scenario: A 40-year-old male with a recent viral illness presents with sharp chest pain that worsens when lying down.

Pulmonary Embolism

• What it is: Blood clot in pulmonary arteries.

• Causes: DVT, prolonged immobility, surgery.

• Signs: Sudden sharp chest pain, shortness of breath, tachycardia, hemoptysis.

• Scenario: A 50-year-old female post-surgery presents with sudden SOB and chest pain after long car ride.

Cardiac Tamponade

• What it is: Fluid buildup in pericardial sac compressing the heart.

• Causes: Trauma, pericarditis, post-surgery.

• Signs: Beck’s triad: JVD, muffled heart sounds, hypotension; pulsus paradoxus.

• Scenario: A 60-year-old male with recent heart surgery presents with shortness of breath, weak pulse.

Aortic Dissection

• Tearing of the aorta lining

• Sudden “ripping/tearing” chest pain → radiates to back

• Unequal BPs in arms

• Often mistaken for MI

GERD

• Stomach acid irritation

• Burning chest pain after eating/lying down

• Mimics cardiac pain

• Relief with antacids

Costochondritis

• Inflammation of chest wall cartilage

• Reproducible pain on palpation (KEY test clue)

• Sharp, localized

Esophageal Rupture (Boerhaave)

• Tear in esophagus (usually after vomiting)

• Severe chest pain + subcutaneous emphysema

• Very serious