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Case – Chest Pain DR DANIEL ROBINSONObjectives u To discuss the wide list of differentials that can fall under the wide umbrella of “chest pain” u To approach these patients in a systematic and safe way u To manage these patients with appropriate interventionsThe Patient u Mr N.E. One, a 53 year old chap coming in with chest pain and shortness of breath u From the end of the bed he looks dyspnoeic, but comfortable u What could be going on? u What do you want to know from the patient?Examination u Talk me through the exam u What are you looking for and why – how does this change your thinking?What do we think is going on?Investigations u What investigations can we do for chest pain u What are we looking for u If you get stuck think about Blind Surgeons Retiring Early u Also think practicallyBloods u FBC - WCC 3.32, Hb 143, Plt 201, MCV 80.7, Neuts 2.79 u CRP 156, Trop 40, D-Dimer 2.68 u U+E - Na 130, K 4.5, Ur 6.8, Cr 89, eGFR 77 u LFTs - BR 23, ALP 58, GGT 21, Prot 59, Alb 40Any new Differential Diagnoses?OK… What next? u What is your plan from here? u What we did and whyPoints for Reflection u Wide differential for Chest pain u CXR is a vital investigation u Not only to rule in, but to rule out u Urgent escalation upwards is key u Develop basic skills in interpretationObjectives u To discuss the wide list of differentials that can fall under the wide umbrella of “chest pain” u To approach these patients in a systematic and safe way u To manage these patients with appropriate interventions THANK YOU FEEDBACK LINK