| Characteristic | Myocardial Infarction | Pericarditis | Gastric Disorders | Angina Pectoris | Dissecting Aneurysm | Pulmonary Embolism |
|---|
| Onset | Gradual or sudden | Sudden | Gradual or sudden | Gradual or sudden | Abrupt, without prodromal symptoms | Gradual or sudden |
| Precipitating factors | Can occur at rest or after exercise or emotional stressss | Breathing deeply, rotating trunk, recumbency, swallowing or yawning | Inflammation of stomach or esophagus; hypersecretion of gastric juices; some medications | Usually after: physical exertion, emotional stress, eating, exposure to cold, or defecation; unstable angina occurs at rest | Hypertension | Immobility or prolonged bedrest following: surgery, trauma, hip fracture, HF, malignancy, oral contraceptives |
| Location | Substernal, anterior chest, or midline; rarely back; radiates to jaw or neck | Precordial; radiates to neck or left shoulder and arm | Xiphoid to umbilicus | Substernal, anterior chest; poorly localized | Correlates with site of intimal rupture; anterior chest or back; between shoulder blades | Pleural area, retrosternal area |
| Quality | Crushing, burning, stabbing, squeezing or vicelike | Pleuritic, sharp | Aching, burning, cramplike, gnawing | Squeezing, feeling of heavy pressure; burning | Sharp, tearing or ripping sensation | Sharp, stabbing |
| Intensity | Asymptomatic to severe; increases with time | Mild to severe | Mild to severe | Mild to moderate | Severe and unbearable; maximal from onset | Aggravated by breathing |
| Duration | 30 min to 1–2 hr; may wax and wane | Continuous | Periodic | Usually 2–10 min; average 3–5 min | Continuous; does not abate once started | Variable |
| Relief |  Narcotics |  Sitting up, leaning forward | Physical and emotional rest, food, antacids, H2-receptor antagonists | Nitro-glycerin, rest | Large, repeated doses of narcotics | O2; sitting up; morphine |
| Associated symptoms | Nausea, fatigue, heartburn; peripheral pulses equal | Fever, dyspnea, nausea, anorexia, anxiety | Nausea, vomiting, dysphagia, anorexia, weight loss | Belching, indigestion, dizziness | Syncope, loss of sensations or pulses, oliguria; discrepancy between BP in arms; decrease in femoral or carotid pulse | Dyspnea, tachypnea, diaphoresis, hemoptysis, cough, apprehension |