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It is not always possible to be certain about the origin of chestpain just by its characteristics as the variation between individuals is quite a bit. A medical opinion should be sought in case of any significant chestpain so that important ailment is not missed. A pain lasting more than 30 minutes is usual.
The main heart attack symptoms assessed by the study were: Chestpain or discomfort Shortness of breath Pain or discomfort in arms or shoulders Feeling weak, lightheaded, or faint Jaw, neck, or back pain Reference Mahajan S, Valero-Elizondo J, Khera R, Desai NR, Blankstein R, Blaha MJ, Virani SS, Kash BA, Zoghbi WA, Krumholz HM, Nasir K.
A 48 year-old female with hypertension, hyperlipidemia, chronic low back pain, and bilateral lower extremity neuropathy. She presents with chestpain and nonspecific EKG changes undergoes a one day myocardial perfusion stress test with Tc99m Sestamibi. Left ventricular systolic function at rest was normal with LVEF of 68%.
CT coronary angiogram is useful to rule out significant blocks in in those presenting with chestpain to the emergency department. CT angiogram is useful in detecting major blocks in these blood vessels. Now the big question, who should have a CT coronary angiogram?
This can block smooth flow of blood and the person can develop chestpain. As age advances and depending on risk factors like heredity, smoking, high blood pressure and diabetes, fat build up occurs in these blood vessels.
In those coming to emergency department with severe chestpain or upper back pain, if there is a large difference in the blood pressure between the arms, this serious condition has to be thought of. Blood seeps into the wall of the aorta and spreads along the wall of the aorta.
So this is a typical Brugada syndrome ECG, which can be easily mistaken for an acute myocardial infarction with ST elevation in anterior leads may be taken as STEMI if the person presents with chestpain for some other reason.
Inflammation of pericardium as inflammation elsewhere can be painful and cause chestpain. But pericardial effusion can build up slowly without much pain. Usually other investigations to search for the location and spread like a positron emission tomography (PET scan) may be considered.
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