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Unstable Angina Pectoris - requiring emergency medical treatment but not primary intervention as in a myocardial infarction Myocardial infarction ("heart attack") Pericarditis and cardiac tamponade Arrhythmia - atrial fibrillation and a number of other arrhythmias can cause chest pain. Stable Angina Pectoris - this can be treated medically and although it warrants investigation, it is not an emergency in its strictest sense Pneumothorax and Tension pneumothorax Pleurisy - an inflammation which can cause painful respiration Gastroesophageal reflux disease (GERD) and other causes of heartburn Hiatus hernia (which may not accompany GERD) Achalasia, nutcracker esophagus and other neuromuscular disorders of the esophagus Problems of chest wall structures Costochondritis or Tietze's syndrome - a benign and harmless form of osteochondritis often mistaken for heart disease Herpes zoster commonly known as shingles Hyperventilation syndrome often presents with chest pain and a tingling sensation of the fingertips and around the mouth Bornholm disease - a viral disease that can mimic many other conditions Precordial catch syndrome - another benign and harmless form of a sharp, localised chest pain often mistaken for heart disease High abdominal pain may also mimic chest pain The physician's typical approach is to rule out the most dangerous causes of chest pain first (e.g., heart attack, blood clot in the lung, aneurysm). By sequential elimination or confirmation from the most serious to the least serious causes, a diagnosis of the origin of the pain is eventually made. Often, no definite cause will be found, and the focus in these cases is on excluding severe diseases and reassurance. If acute coronary syndrome ("unstable angina") is suspected, many patients are admitted briefly for observation, sequential ECGs, and determination of cardiac enzyme levels over time (CK-MB, troponin or myoglobin). On occasion, later out patient testing may be necessary to follow up and make better determinations on causes and therapies. As in all medicine, a careful medical history and physical examination is essential in separating dangerous from trivial causes of disease, and the management of chest pain is often done on specialised units (termed medical assessment units) to concentrate the investigations. A rapid diagnosis can be life-saving and often has to be made without the help of X-rays or blood tests (e.g. aortic dissection). Occasionally, invisible medical signs will direct the diagnosis towards particular causes, such as Levine's sign in cardiac ischemia. Generally, however, additional tests are required to establish the diagnosis. An emergency medicine doctor will also focus on recent health changes, family history (premature atherosclerosis, cholesterol disorders), tobacco smoking, diabetes and other risk factors. Features of the pain suggest of cardiac ischaemia are describing the pain as heaviness; radiation of the pain to neck, jaw or left arm; sweating; nausea; palpitations; the pain coming upon exertion; dizziness; shortness of breath and a "sense of impending doom." On the basis of the above, a number of tests may be ordered: X-rays of the chest and/or abdomen (CT scanning may be better but is often not available) V/Q scintigraphy or CT pulmonary angiogram(when a pulmonary embolism is suspected) Electrolytes and renal function (creatinine) Creatine kinase (and CK-MB fraction in many hospitals) Troponin I or T (to indicate myocardial damage) D-dimer (when suspicion for pulmonary embolism is present but low) serum amylase to exclude acute pancreatitis Chest pain is the presenting symptom in about 12% of emergency departement visits in the United States and has a one year mortality of about 5%. Stephen J. Dubner; Steven D. Levitt (2009). SuperFreakonomics: Tales of Altruism, Terrorism, and Poorly Paid Prostitutes. New York: William Morrow. pp.77. ISBN 0-06-088957-8. Headache Neck Odynophagia (swallowing) Otalgia (ear) Toothache Abdomen Back (Upper, Lower) Chest Mastodynia (Breast) Arthralgia (joint) Bone pain Myalgia (muscle) Cold pressor test Delayed onset muscle soreness Congenital insensitivity to pain Dolorimeter HSAN (Type I, II congenital sensory neuropathy, III familial dysautonomia, IV congenital insensitivity to pain with anhidrosis, V congenital insensitivity to pain with partial anhidrosis) Neuralgia Pain asymbolia Pain disorder Paroxysmal extreme pain disorder Allodynia Breakthrough pain Chronic pain Hyperalgesia Hypoalgesia Hyperpathia Phantom pain Referred pain Anterolateral system Pain management (Anesthesia, Cordotomy) Pain scale Pain threshold Pain tolerance Posteromarginal nucleus Substance P Suffering OPQRST Symptoms and signs: respiratory system (R04-R07, 786) Respiratory sounds: Stridor Wheeze Rales Rhonchi Hamman's sign Dyspnea Hyperventilation/Hypoventilation Hyperpnea/Tachypnea/Bradypnea Orthopnea/Platypnea Biot's respiration Cheyne-Stokes respiration Kussmaul breathing Hiccup Mouth breathing/Snoring Breath-holding Asphyxia Cough Pleurisy Sputum Pectoriloquy: Whispered pectoriloquy Egophony Bronchophony respiratory system navs: anat nose, larynx/lower+thoracic cavity/physio/dev, noncongen/congen/tumors, symptoms+signs/eponymous, proc Categories: SymptomsHidden categories: Articles lacking sources from January 2010 All articles lacking sources We are high quality suppliers, our products such as aaa battery tester Manufacturer , tension tester Manufacturer for oversee buyer. 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