The Five Deadly Causes of Chest Pain Other than Myocardial Infarction

Calls for chest pain are exceedingly common in EMS and result in more than 8 million ED visits yearly in the United States.1 Of these, almost 1 million may have an acute coronary syndrome (ACS) and about a third of these will have a myocardial infarction (MI).2 Although the vast majority of chest pain patients don't have either ACS or another emergency, EMS providers must be experts in recognizing all of the potential lethal causes of chest pain. In this article we'll discuss common presentations of ACS and then review the five other acute deadly causes of chest pain: aortic dissection, pericarditis with tamponade, esophageal perforation, pulmonary embolus and tension pneumothorax. Although all may initially appear very similar with chest pain, hypotension, shortness of breath or as a patient in extremis, each has some important red flags to be on the lookout for. Making matters even more confusing, although the ECG findings of ST elevation or T-wave inversion usually support the diagnosis of ACS, MI-like ECG changes can be seen with each of the other life-threatening causes of chest pain. Classic & Atypical ACS Classic angina presents with substernal chest pain that's described as "squeezing" or "pressure-like." It often radiates to the arms or jaw and is made worse by exertion or emotion and made better by rest or nitroglycerin.3
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Cardiac & Resuscitation Source Type: news