(1) Cervical disk disease; (2) osteoarthritis of cervical or thoracic spine; (3) abdominal disorders: peptic ulcer, hiatus hernia, pancreatitis, biliary colic; (4) tracheobronchitis, pneumonia; (5) diseases of the breast (inflammation, tumor); (6) intercostal neuritis (herpes zoster).
Approach to the Patient: Chest Pain A meticulous history of the behavior of pain, what precipitates it and what relieves it, aids diagnosis of recurrent chest pain. Figure 31-2 presents clues to diagnosis and workup of acute, life-threatening chest pain. An ECG is key to the initial evaluation to rapidly distinguish pts with acute ST-elevation MI, who typically warrant immediate reperfusion therapies (Chap. 119. ST-Segment Elevation Myocardial Infarction). |
For a more detailed discussion, see Morrow DA: Chest Discomfort, Chap. 19, p. 95, in HPIM-19. |
Section 3. Common Patient Presentations