Chest Wall Pain
Variable, often unclear
Often below the left breast or along the costal cartilages; also elsewhere
Stabbing, sticking, or dull, aching
Variable
Anxiety
Unclear
Precordial, below the left breast, or across the anterior chest
Stabbing, sticking, or dull, aching
Variable
Note: Remember that chest pain may be referred from extrathoracic structures such as the neck (arthritis) and abdomen
(biliary colic, acute cholecystitis). Pleural pain may be due to abdominal conditions such
as subdiaphragmatic abscess.
Timing
Factors That Aggravate
Factors That Relieve
Usually 1-3 min but up to Exertion, especially in the cold; meals; Rest, nitroglycerin 10 min. Prolonged episodes emotional stress. May occur at rest up to 20 min
Sometimes dyspnea, nausea, sweating
20 min to several hr
Persistent
Persistent
Breathing, changing position, coughing, lying down, sometimes swallowing
Abrupt onset, early peak, Hypertension persistent for hours or more
Nausea, vomiting, sweating, weakness
Sitting forward may relieve it. Of the underlying illness
Of the underlying illness
Syncope, hemiplegia, paraplegia
Variable Persistent
Coughing
Breathing, coughing, movements of the trunk
Cough
Lying on the involved side may Of the underlying illness relieve it.
Variable Variable
Fleeting to hours or days Movement of chest, trunk, arms
Large meal; bending over, lying down Antacids, sometimes belching Sometimes regurgitation, dysphagia
Sometimes nitroglycerin Dysphagia
Swallowing of food or cold liquid; emotional stress
Often local tenderness
Fleeting to hours or day
May follow effort, emotional stress
Breathlessness, palpitations, weakness, anxiety
TABLE 6-2 ■ Dyspnea |
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