Chest pain - what and where?
In the emergency department chest pain is the 2nd most common pathology. Thus, identifying the causes of chest pain may be in use for any medical specialist. Let's check the main facts published by StatPearls. First, it is important to consider the 2 different etiologies of pain: visceral pain (mainly vague distribution pattern), and somatic pain (usually localized in a specific spot). Main causes reported are: acute coronary syndrome (31%), gastrointestinal reflux disease (30%) and musculoskeletal causes (28%). History and physical is described in detail by the link. The first line diagnostics include electrocardiogram, chest X-Ray, complete blood count and troponin level, computed tomography pulmonary angiography (in the risk of pulmonary embolism) and bedside ultrasound for pericardial tamponade. It is essential to get the right diagnosis first, as the treatment strategy varies greatly.
