|
Acute Chest Pains |
|
Signs and Symptoms: Both exhibit sever retrosternal pain characterized by a crushing or band-like heavy pain. It is classically preceded by effort, emotion or excitement, and may radiate to the arms, neck, jaw, and occasionally to the back or abdomen. Angina ¨ Stop the procedure ¨ Give glyceryl trinitrate 0.5mg sublingually or 0.4mg spray, or isosorbide dinitrate 5mg sublingually, or nifedipine 5mg capsule (bitten).
Failure of these methods to relieve the pain, and persistent sweating, breathlessness, nausea, vomiting, or loss of consciousness with a weak or irregular pulse suggests an infarct.
Myocardial Infarction ¨ Stop the procedure ¨ Call for medical assistance immediately ¨ Give oxygen ¨ Give diamorphine 5mg IM or IV as analgesic plus 12.5mg prochlorperazine IM as antiemetic ¨ Lie patient flat only if hypotensive ¨ Get ECG, U&Es ¨ Be prepared to start cardiopulmonary resuscitation
|
|
Severe, acute chest pain is usually the result of ischaemia of the myocardium. Both angina and myocardial infarction can be considered in the differential diagnosis. |
