Pre PACES Podcast #93 Chest pain
Aug 4, 2024
In this engaging discussion, Dr. Retesh Bajaj, an interventional cardiologist and PACES instructor, teams up with Dr. Bunny Saberwal, also an interventional cardiologist with a focus on Intelligent PACES. They dive into the complexities of chest pain, covering acute coronary syndromes, historical features that reduce ACS probability, and the pitfalls of misdiagnosing aortic dissection. Their insights on pleuritic pain, mimics of cardiac issues, and the role of echocardiography provide valuable knowledge for both clinical practice and exam preparation.
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What 'Acute Coronary Syndrome' Really Means
- Acute coronary syndrome usually means reduced coronary blood flow from plaque rupture causing clot formation.
- Other causes like coronary vasospasm or embolic MI are rarer but clinically relevant.
Structure Chest Pain History With Socrates
- Ask open questions first and then use Socrates to tease out chest pain character and triggers.
- Clarify alleviating/exacerbating factors and risk factors to discriminate cardiac pain from others.
Use Character And Exertion To Triage Risk
- Use the pain's character and exertional association to judge likelihood of ischemia.
- If pain worsens with exertion and is heavy/squeezing, raise suspicion for coronary ischemia.