Should clinicians evaluate each complaint of chest pain as if it's new?
This case shows that clinicians must always evaluate each complaint of chest pain as if it were new. Additionally, patients who complain of chest pain won't always have the expected signs and symptoms.
How can follow-up questions help in the evaluation of chest pain?
Using follow-up questions, such as asking the patient to point to the area of pain, and repeating what the patient said can be very helpful in making sure the patient is understood. Explore the characteristics of the chest pain first.
What is the best way to diagnose chest pain?
However, asking pertinent questions regarding the type of pain the patient is experiencing, performing a thorough objective exam and obtaining the appropriate diagnostic tests will help lead to the correct diagnosis in the initial evaluation of a patient with chest pain.
How can acute care pharmacists help with chest pain?
Acute care pharmacists can facilitate a smooth transition to the community setting for patients who will remain on chronic therapy for conditions causing chest pain. By improving medication therapy management and optimizing quality of care, pharmacists are important members of the multidisciplinary health care team. 8
What assessments should be done for chest pain?
Some of the first tests a health care provider may order when evaluating chest pain include:Electrocardiogram (ECG or EKG). This quick test measures the electrical activity of the heart. ... Blood tests. ... Chest X-ray. ... Computerized tomography (CT) scan.
What assessment tool is a priority in patients with chest pain?
Recording 12 lead ECG has a central role in the early assess- ment of patients with suspected ischaemic chest pain. It is recommended that recording and interpreting a 12 lead ECG within 10 minutes of patient presentation is best practice.
What are your first interventions for a patient experiencing chest pain?
Nursing ManagementManage chest pain.Bed rest.Provide oxygen.Administer aspirin and nitroglycerin.Place patient with head of the bed elevated at 45 degrees.Make patient comfortable.Hook up to monitor.Check vitals.More items...•
What is the first and initial approach to chest pain?
Assessment of all high-risk patients with chest pain should always begin with getting an initial impression then assessing the airway, breathing and circulation paired with vital signs.
When treating a patient with chest pain pressure or discomfort you should first?
If you or someone else may be having a heart attack, follow these first-aid steps:Call 911 or emergency medical assistance. ... Chew aspirin. ... Take nitroglycerin, if prescribed. ... Begin CPR on the person having a heart attack.More items...
What is the nursing management for chest pain?
Nursing Care Plan for Chest Pain 5Nursing Interventions for Chest PainRationalesTeach deep breathing exercises and relaxation techniques such as guided imagery.To allow the patient to relax and to facilitate effective stress management.3 more rows
What is the first intervention for a client experiencing MI?
The first goal for healthcare professionals in management of acute myocardial infarction (MI) is to diagnose the condition in a very rapid manner. As a general rule, initial therapy for acute MI is directed toward restoration of perfusion as soon as possible to salvage as much of the jeopardized myocardium as possible.
What is the first intervention for a patient experiencing an MI?
The immediate concerns for a patient with suspected myocardial infarction should be their safety and comfort. Intravenous access must be available for effective administration of emergency drug therapy followed by rapid transfer to an area with a high level of supervision and resuscitation facilities.
What is the assessment of myocardial infarction?
ECG remains the first line test for myocardial infarction together with the use of biomarkers in the acute setting. Catheter based coronary angiography is used for the diagnosis and treatment of acute coronary syndrome.
When should you refer to chest pain?
Indications for referral Patients with new onset chest pain suspected to be cardiac in origin. Patients with known ischaemic heart disease who have developed new onset or worsening symptoms, who have not been seen previously by a cardiologist.
Introduction
Chest pains are a common complaint in the emergency room. You may be experiencing cardiac chest pain caused by coronary artery disease, arrhythmia, or other conditions that affect the heart.
What is Chest Pain?
Chest pain refers to discomfort, tightness, pressure, or soreness in the chest area. Chest pains are also known as angina pectoris. The most common symptom of a problem with the oesophagus is chest pain. The oesophagus is the tube connecting the mouth and stomach.
Risk Factors for Chest Pain
There are risk factors for both cardiac chest pain and non-cardiac chest pain. These risk factors include:
Nursing Diagnosis for Chest Pain
Your doctor will ask you about your symptoms, do an examination and may also order tests such as X-rays or MRI scans to help determine the cause of your chest pain.
Nursing Care Plans
The purpose of this care plan is to provide a framework for the management of patients who are admitted to the cardiac care unit or other acute settings and require special monitoring.
Nursing Interventions for Chest Pains
The nurse prepares the emergency cardiac care kit and monitors patients for signs that may indicate their condition is worsening, including increasing pain, abdominal discomfort or chest pains; respiratory distress; shortness of breath and coughing up blood.
Treatment
Cardiac rehabilitation programs begin with a cardiac event and incorporate the following elements: behavioral change, education, exercise training, emotional support, smoking cessation and social support. The program’s goal is to reduce or eliminate the risk of another heart attack while improving physical condition and quality of life.
What is chest pain management?
The goal of chest pain management, as with all pain control, is to find the cause and treat it appropriately, with the right medication at the lowest effective dose with the fewest possible side effects.
What is chest pain?
Specifically, chest pain is usually characterized by an unpleasant sensation localized to the thorax. 1 Descriptions of chest pain vary widely, involving terms like “burning,” “aching,” “stabbing,” or “pressure.” 2. One of the most significant factors in the appraisal of chest pain is the distinction between cardiac and noncardiac chest pain.
Why does my chest hurt when I eat?
GI disorders are a common source of noncardiac chest pain. Gastroesophageal reflux disease (GERD), one of the most common causes of noncardiac chest pain, presents with pain resembling angina. 14 GERD may be associated with a squeezing or burning type of substernal pain that radiates to the neck, back, or arms. 6,14 The pain is generally worse after meals and in the supine position, and exercise and emotional stress can precipitate GERD-associated pain. 11 GERD has been reported in as many as 60% of people with chest pain. 13,14
What is the name of the condition that causes a burning sensation in the left shoulder?
Angina , the classic manifestation of myocardial ischemia, is usually described as heavy chest pressure or a squeezing or burning sensation and is often accompanied by difficulty breathing. Angina often radiates to the left shoulder, neck, or arm and builds in intensity over a period of several minutes. 6 While exercise or psychological stress can trigger angina , the condition most commonly occurs without obvious precipitating factors. 3,6 The typical presentation includes pain that is substernal, provoked by exertion, and relieved by rest or nitroglycerin. 3,4 Anginal chest pain indicates a high risk of CAD. 4
What causes chest pain?
These conditions include acute coronary syndrome (ACS), pulmonary embolism (PE), and aortic dissection. 1-3,9 ACS is the most significant potentially fatal diagnosis of chest pain.
Why does my chest hurt when I'm not acardiac?
One common cause of noncardiac chest pain is costochondritis, the inflammation of a rib or cartilage attached to a rib. This condition is relieved by analgesics, local anesthetics, or anti-inflammatory agents. Infectious diseases such as herpes zoster may also cause diffuse chest pain.
What are the symptoms of a heart attack?
2,3 In order to recognize patients in need of prompt and potentially life-saving intervention, the National Heart Attack Alert Program recommends the immediate assessment of patients with the following symptoms: chest pain, pressure, tightness, or heaviness, or pain that radiates to the neck, jaw, shoulders, back, or arms; indigestion, heartburn, or nausea and/or vomiting associated with chest pain; persistent shortness of breath; or weakness, dizziness, lightheadedness, or loss of consciousness. 6
How long does chest pain last?
A; Chest pain, pressure, or discomfort (usually lasting greater than 15 minutes) is present in the majority of patients experiencing acute myocardial infarction (AMI). Other common signs and symptoms include shortness of breath, nausea, and diaphoresis.
What are the symptoms of ACS?
C; Chest pain, pressure, or discomfort is the most common symptom of acute coronary syndrome, or ACS (eg, unstable angina, acute myocardial infarction); it occurs in approximately 80% of cases. Patients with ACS are usually anxious and may have a feeling of impending doom. Nausea and vomiting are common complaints; however, projectile vomiting, which is typically associated with increased intracranial pressure, is uncommon. The skin is often ashen gray and clammy (diaphoretic) because of poor cardiac output and decreased perfusion. Less commonly, the patient's skin is cyanotic. Respirations are usually unlabored unless the patient has congestive heart failure, in which case respirations are rapid and labored; irregular breathing, however, is not common. Blood pressure may fall as a result of decreased cardiac output; however, most patients will have a normal or elevated blood pressure. If the patient complains of a headache, it is usually a side effect of the nitroglycerin they took before your arrival; ACS itself usually does not cause a headache.
How long does it take to feel a carotid pulse?
C: feel for a carotid pulse for at least 5 seconds.
Why is the mid-upper region of the abdomen called the epigastrium?
D; The mid-upper region of the abdomen is referred to as the epigastrium because of its location over the stomach (epi = upon, gastric = stomach). This is a common site of pain or discomfort in patients experiencing a cardiac problem, which frequently causes them to attribute their pain or discomfort to indigestion.
When is a patient's face symmetrical?
B: The patient's face is symmetrical when he or she smiles.
Does aspirin help with chest pain?
Aspirin does not relieve the chest pain or discomfort associated with ACS, nor does it reduce blood pressure. Furthermore, aspirin does not destroy the clot that is blocking a coronary artery; fibrinolytic (clot-buster) drugs actually destroy the clot.
Is chest pain reproducible?
Pain of cardiac origin typically is not reproducible by palpation. Palpable pain to the chest suggests a musculoskeletal problem, not a cardiac problem. However, because some patients with a cardiac problem present atypically, you should transport any patient with chest pain, pressure, or discomfort to the hospital.
What is the best way to check for chest pain?
Stress tests. These measure how your heart and blood vessels respond to exertion, which may indicate if your chest pain is heart-related. There are many kinds of stress tests. You may be asked to walk on a treadmill or pedal a stationary bike while hooked up to an ECG.
What to do if your chest hurts when you have a panic attack?
Antidepressants. If you're experiencing panic attacks, your doctor may prescribe antidepressants to help control your symptoms.
What is the procedure for a blockage in the heart?
Angioplasty and stent placement. Chest pain that is caused by a blockage in an artery feeding the heart is typically treated with angioplasty. The doctor inserts a catheter with a balloon on the end into a large blood vessel, usually in the groin, and guides the catheter to the blockage. The doctor inflates the balloon to widen the artery, then deflates it and removes the catheter. A small wire mesh tube (stent) is often placed on the outside of the balloon tip of the catheter. When expanded, the stent locks into place to keep the artery open.
What to do if you have a heart attack?
Aspirin. If doctors suspect that your chest pain is related to your heart, you'll likely be given aspirin. Thrombolytic drugs. If you are having a heart attack, you may receive these clot-busting drugs. These work to dissolve the clot that is blocking blood from reaching your heart muscle. Blood thinners.
What is chest xray?
Chest X-ray. An X-ray of your chest allows doctors to check the condition of your lungs and the size and shape of your heart and major blood vessels. A chest X-ray can also reveal lung problems such as pneumonia or a collapsed lung. Computerized tomography (CT scan). CT scans can spot a blood clot in your lung (pulmonary embolism) ...
What is the procedure to repair a collapsed lung?
Dissection repair. You may need emergency surgery to repair an aortic dissection — a life-threatening condition in which the artery that carries blood from your heart to the rest of your body ruptures. Lung reinflation. If you have a collapsed lung, doctors may insert a tube in your chest to reinflate the lung.
What causes chest pain?
Procedures to treat some of the most dangerous causes of chest pain include: Angioplasty and stent placement. If your chest pain is caused by a blockage in an artery feeding your heart, your doctor will insert a catheter with a balloon on the end into a large blood vessel in your groin, and thread it up to the blockage.