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American Family Physician Sep 2017Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most...
Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made. Validated clinical decision rules are available to help exclude coronary artery disease. Viruses are common causative agents of pleuritic chest pain. Coxsackieviruses, respiratory syncytial virus, influenza, parainfluenza, mumps, adenovirus, cytomegalovirus, and Epstein-Barr virus are likely pathogens. Treatment is guided by the underlying diagnosis. Nonsteroidal anti-inflammatory drugs are appropriate for pain management in those with virally triggered or nonspecific pleuritic chest pain. In patients with persistent symptoms, persons who smoke, and those older than 50 years with pneumonia, it is important to document radiographic resolution with repeat chest radiography six weeks after initial treatment.
Topics: Algorithms; Aorta; Chest Pain; Coronary Artery Disease; Decision Support Techniques; Diagnosis, Differential; Diagnostic Imaging; Humans; Medical History Taking; Myocardial Infarction; Pericarditis; Physical Examination; Pleural Effusion, Malignant; Pneumonia; Pneumothorax; Pulmonary Embolism
PubMed: 28925655
DOI: No ID Found -
Heart (British Cardiac Society) Oct 2021
PubMed: 34521735
DOI: 10.1136/heartjnl-2021-319721 -
Journal of the American College of... Jun 2023
PubMed: 37180954
DOI: 10.1002/emp2.12960 -
Clinical Practice and Cases in... Feb 2023We describe a case of epipericardial fat necrosis.
CASE PRESENTATION
We describe a case of epipericardial fat necrosis.
DISCUSSION
Epipericardial fat necrosis is an inflammatory condition in which the pericardial fat pad necrotizes resulting in surrounding inflammation. This condition mimics more ominous pathology in clinical presentation and radiographic findings. Management is supportive with oral analgesics.
PubMed: 36859328
DOI: 10.5811/cpcem.2022.10.57915 -
Breathe (Sheffield, England) Mar 2020http://bit.ly/2JRAk6H.
http://bit.ly/2JRAk6H.
PubMed: 32494299
DOI: 10.1183/20734735.0294-2019 -
Lancet (London, England) Nov 2013
Topics: Adult; Chest Pain; Diagnosis, Differential; Female; Homocystinuria; Humans; Pleurisy; Radiography
PubMed: 24290590
DOI: 10.1016/S0140-6736(13)62547-7 -
Pediatric Pulmonology Feb 2023
Topics: Humans; Pulmonary Embolism; Pleurisy; Chest Pain
PubMed: 36251521
DOI: 10.1002/ppul.26211 -
Australian Family Physician Nov 2017Pericarditis is an important diagnosis to consider, along with various other differential diagnoses, in a patient who presents with chest pain.
BACKGROUND
Pericarditis is an important diagnosis to consider, along with various other differential diagnoses, in a patient who presents with chest pain.
OBJECTIVE
This article describes in detail the common features, management and complications of pericarditis in the general practice setting.
DISCUSSION
Characteristic clinical findings in pericarditis include pleuritic chest pain and pericardial friction rub on auscultation of the left lower sternal border. Electrocardiography may reveal diffuse PR-segment depressions and diffuse ST-segment elevations with upward concavity. The most common aetiologies of pericarditis are idiopathic and viral, and the most common treatment for these are nonsteroidal anti-inflammatory drugs and colchicine. The complications of pericarditis include pericardial effusion, tamponade and myopericarditis. The presence of effusion, constriction or tamponade can be confirmed on echocardiography. Tamponade is potentially life-threatening and is diagnosed by the clinical findings of decreased blood pressure, elevated jugular venous pressure, muffled heart sounds on auscultation and pulsus paradoxus.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Chest Pain; Diagnosis, Differential; Electrocardiography; Friction; Humans; Pericarditis
PubMed: 29101915
DOI: No ID Found -
Annals of Emergency Medicine Aug 2021
Topics: Bronchoscopy; Chest Pain; Foreign-Body Migration; Hemoptysis; Humans; Male; Trachea; Wounds, Gunshot
PubMed: 34325863
DOI: 10.1016/j.annemergmed.2021.03.001 -
Breathe (Sheffield, England) Jun 2022https://bit.ly/3MJXrhk.
https://bit.ly/3MJXrhk.
PubMed: 36337121
DOI: 10.1183/20734735.0007-2022