However, the AHA has gone above and beyond to summarize this info, and in such a clever way. This is an exhaustive guideline on the evaluation and diagnosis of chest pain. So, what’s the latest, best thinking on the chest pain workup? That said, we can’t image or cath everyone who walks in. Using the acrostic CHEST PAINS, the AHA has issued outstanding new guidelines on the chest pain workup.Ĭhest pain is one of the most common problems we see in the ED, and the stakes are high if we get this wrong. Please drop your questions for this town hall into this Google Form. Let’s be curious, kind, and learn how we can better care for each other. Nick Z., Eriny, and I will curate your questions and comments and present this podcast to you in early 2022. We are planning a podcast with Cortlyn Brown, Kimberly Brown, Italo Brown, and Rosny Daniel, and you are asking the questions! Talking together as friends and colleagues is powerful. St Louis, MI: Elsevier.Incredibly thought provoking questions so far! Add yours! Today’s article summary is below but first a quick announcement. Mosby's Dictionary of Medicine, Nursing & Health Professions (10th ed). Redditch: National Health Service (NHS) England. In rare cases, where the condition does not respond to medical treatment, surgery to remove the inflamed cartilage may be required. If the pain is extreme and/or prolonged, a corticosteroid medication such as hydrocortisone may be injected into the affected area to help reduce pain and inflammation.
Ice and/or heat packs applied to the area.Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and pain-relieving medications such as paracetamol.Rest and avoiding activities that worsen the pain.Where treatment is required, the aim is to reduce inflammation and control pain. Often the symptoms of costochondritis resolve without treatment. An electrocardiogram (ECG), which is a tracing of the heart’s electrical activity.Sometimes tests to rule out other more serious conditions may be recommended: DiagnosisĪ diagnosis of costochondritis can usually be made by assessing the nature of the symptoms and by the fact the pain can be reproduced by pressing on the affected area. If the onset of pain is sudden, contact emergency services or a doctor. However, the pain of a heart attack covers the whole chest and is often accompanied by shortness of breath, nausea and sweating. Symptoms of costochondritis usually last for between one and three weeks.Ĭostochondritis symptoms can be mistaken for a heart attack. The pain usually occurs on only one side of the chest, most commonly the left, but can affect both sides of the chest at the same time. It is usually located on the front of the chest, but can radiate to the back, abdomen, arm or shoulder. It may be described as pressure, aching or sharp pain. The pain can vary in intensity but is often severe.
Pressure placed directly on the affected area will also cause significant pain.
The pain increases with movement and deep breathing and decreases with rest and quiet breathing. The main symptoms of costochondritis are pain and tenderness at the junction of the ribs and the breastbone as a result of cartilage tissue between the bones becoming inflamed. Costochondritis can occur after a respiratory illness such as a cold or flu and in people with underlying conditions including fibromyalgia, systemic lupus erythematosus and ankylosing spondylitis.Ĭostochondritis affects females more often than males, and more commonly occurs in adolescents and young adults. It can be associated with an injury to the rib cage or with unusual physical activity or strain (eg: heavy lifting or severe coughing). There is often no definitive cause for costochondritis. The sudden onset of chest pain should be assessed immediately by emergency services or a doctor. However, it can cause anxiety as its symptoms may be mistaken for a heart attack. Costochondritis is a relatively harmless condition that will usually go away without treatment.
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