Presentations
FLORENCE BLACKMAN IHUMAN CASE
STUDY 49-YEAR-OLD FEMALE DIAGNOSED
WITH CHEST PAIN
Acute coronary syndrome (unstable angina,MI) - answer-*Cardiovascular, ischemic*
- Heaviness; viselike, squeezing, crushing, tightness; vague, burning, constricting, or
pressure; poorly localized pain lasting 20-30 minutes to hours and does not resolve with
rest
- Generalized substernal or retrosternal: can radiate to teeth, jaw, neck, one or both
arms or shoulders; or there may be no pain and only associated symptoms
- Indigestion-like feeling, nausea, vomiting, dizziness, flushing, perspiration, palpitations,
dyspnea
Cholecystitis - answer-*GI*
- Sudden onset of pain that crescendos and can last for up to 20 minutes, usually after
eating a fatty meal
- Epigastrium or right upper abdomen that can radiate to right intrascapular region,
shoulder, or back
- Nausea, vomiting, anorexia, fever
Pancreatitis - answer-*GI*
- Sudden dull, boring, steady pain unrelieved by lying supine; leaning forward or the
fetal position may ease pain
- Epigastrium or periumbilical pain radiating to back
- Nausea, vomiting, anorexia, and sometimes diarrhea
Herpes zoster - answer-*Dermatologic*
- Unilateral, burning, borelike pain
- Chest region in dermatome distribution
- Tingling, itching, burning
Pericarditis - answer-*Cardiovascular, non-ischemic*
- Sudden sharp and stabbing pain relieved often by sitting or leaning forward and
worsens by lying down or with inspiration
- Substernal, which can radiate to trapezius muscle region
- Dry cough, muscle and joint aches, fever
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