1. CHEST PAIN Causes How to differentiate each pain (symptoms) Risk factors (associated diseases) Physical signs Investigations Complications and treatment (don’t bother)

2. CHEST PAIN Causes (differential diagnosis) cardiac: ischaemic (angina pectoris, myocardial infarction) pericarditis dissecting aortic aneurysm pulmonary embolism

3. CHEST PAIN Causes (cont’d) noncardiac: pneumothorax pleuritic local (neuro,musculoskeletal) abdominal:gall bladder peptic ulcer pancreatitis

4. CHEST PAIN How to differentiate: character site radiation duration precipitating factors relieving factors associated symptoms

5. CHEST PAIN Risk factors: hypertention hyperlipidaemia diabetes mellitus smoking + family history obesity

6. CHEST PAIN Physical signs: hypertension / hypotension weak / irregular pulses atherosclerosis signs added heart sounds murmurs pericardial rub lung crepitations local tenderness abdominal tenderness

7. CHEST PAIN Investigations: cardiac enzymes resting ECG CXR stress ECG echocardiogram angiogram (catheterization) CT MRI