Run of Chest Pains

[RocketMedic]

Today has been a streak of diabetic, elderly, female chest pressure/pain/tenderness with extremely high blood glucose levels and shortness of breath associated with new-onset chest pain. Both were in Afib. Pain and SHOB relieved with nitro and fentanyl in one case, nitro only in the other. Lungs both diminished all around. Apparently, neither of them are cardiac patients (per the facilities). I feel a little bad about triaging them as cardiac now, both were apparently endocrine problems and CHF exacerbation. I know its cardiac (somewhat), but I was thinking MI on both. Not sure on the ER diagnosis on either.

 

[Veneficus]

I have seen a lot (more than I can possibly recall) of CHF patients who go into Afib when they have an exacerbation, which usually self resolves with treatment.

One of the first questions I ask patients when trying to differentiate COPD from CHF exacerbation in patients with both is if they have a history of afib.

If I see it on the monitor and they have no idea or say "no", I start to lean more towards CHF.

 

[blachatch]

I have seen a lot (more than I can possibly recall) of CHF patients who go into Afib when they have an exacerbation, which usually self resolves with treatment.

One of the first questions I ask patients when trying to differentiate COPD from CHF exacerbation in patients with both is if they have a history of afib.

If I see it on the monitor and they have no idea or say "no", I start to lean more towards CHF.

very helpful assessment tip thank you