Critical Care >Acute Cardiac Ischemia

John M. Oropello, Stephen M. Pastores, Vladimir Kvetan+

Table 24–2Differential diagnosis of acute chest pain in the intensive care unit.

Diagnosis Historical Features

Pleuritic
Pulmonary embolism

Venous thromboembolism risk factors may be present

Fever
Pneumonia

Productive cough

Tearing quality

Aortic dissection
Sudden onset

Radiation to back

Gastritis/esophageal reflux May vary with meals or antacids

Esophageal spasm May improve with nitrates

Positional
Pericarditis

Pleuritic

Localized
Musculoskeletal

May be elicited with palpation, motion or sometimes respiration

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