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Assessing Chest Discomfort


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Onset of Angina
Sudden & in response to exertion, temps, emotional state..
Squeezing vise-like pain (15 min, relieved with rest).
Onset of MI
Sudden with nothing precipitating and frequently seen early in the morning; between 3AM and 5AM.
(Could present --) Intense stabbing, severe viselike pain, pressure. Lasts 30 mins or longer.
Pericarditis - Inflammation of the pericardium.
Sudden, sharp, stabbing (5-10 on scale).
Intermittent pain; stops when sitting upright, analgesia, NSAIDs.
Pleuropulmonary - Pain felt within the lungs or the pleura.
Moderate ache that worsens on inspiration -- felt within lung fields.
Squeezing, heartburn.. Relieved with antacid, food, or sitting upright.
Pain caused by Anxiety
May be in response to stress, fatigue, usually last only a few minutes and felt on the left side of the chest as a dull ache or stabbing; numbness in the fingers.
Women's Pain in response to heart disease.
Often more subtle signs than men and usually do not respond to rest or medication. Often reported; back pain, indigestion, nausea, vomiting, anorexia.
The causes of pain heart disease.
Ischemia, pericarditis, aortic dissection
The causes of chest pain not related to heart disease.
Pulmonary embolus, pleurisy, hiatal hernia, anxiety.
Questions to ask about pain.
Did this pain begin suddenly or gradually?
What were you doing when it started?
How long does it last?
Where is the pain? (Have the client point to the area with one finger)
What relieved the pain?

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