Chest Pain

Objectives

1. Given a patient with undefined chest pain, take an adequate history to make a specific diagnosis (e.g., determine risk factors, whether the pain is pleuritic or sharp, pressure, etc.).
2. Given a clinical scenario suggestive of life-threatening conditions (e.g., pulmonary embolism, tamponade, dissection, pneumothorax), begin timely treatment (before the diagnosis is confirmed, while doing an appropriate work-up).
3. In a patient with unexplained chest pain, rule out ischemic heart disease.
4. Given an appropriate history of chest pain suggestive of herpes zoster infection, hiatal hernia, reflux, esophageal spasm, infections, or peptic ulcer disease:
   • Propose the diagnosis.
   • Do an appropriate work-up/follow-up to confirm the suspected diagnosis.
5. Given a suspected diagnosis of pulmonary embolism:
   • Do not rule out the diagnosis solely on the basis of a test with low sensitivity and specificity.
   • Begin appropriate treatment immediately.