Chest Pain History Questions Site Radiation Time questions Previous episodes Context at onset Lifestyle changes Impact on life Anything makes it worse Anything makes it better Associated Features: SOB Dizziness Fainting Palpitations Swelling Leg pain Changes in leg colour Worse when lying flat Sweating nausea Fever Fatigue Vomit Pallor Weight loss Changes to appetite Regurgitation Weakness Anxious Pallor Impending sense of doom. Cough Medications Prescription medications Non-prescription medications. Medical history Ask generally Metabolic disease Cardiovascular diseases Past surgical history Vaccinations Tests Family history Social history: Diet Exercise Travel history Alcohol Smoking Infectious contacts Recreational drug use. Differentials ACS Retrosternal chest pain that is dull and squeezing Radiates to left chest, arm, shoulder, neck, jaw and/or epigastrium. Nausea Pallor Sweating -> diaphoresis Vomiting Dizziness Palpitations SOB Loss of consciousness Sense of impending doom Made worse by physical activity of stress. Better after nitrate administration -> HOWEVER THIS IS NOT PART OF THE DIAGNSOIC Aortic Dissection Sudden Radiates interscapular or retrosternal pain. May migrate to neck and jaw. Abdomen or periumbilical colicky pain. Syncope Diaphoresis Confusion or agitation. Pneumothorax Sudden and severe and/or stabbing ipsilateral chest pain. Dyspnoea Pericarditis Pleuritic chest pain and retrosternal pain caused by inflammation of the parietal pleura. Made worse by coughing, swallowing and deep inspiration. Improves when leaning forward. May radiate to the neck and shoulders -> most commonly on the left. Infective endo carditis Detention Nail changes Finger changes Fever PE Sudden onset Cough and haemoptysis Fever (low grade) Palpitations SOB Impending sense of doom. Pleuritic chest pain Associated DVT features: Unilateral painful leg swelling If big PE: Presyncope and/or syncope JVD Kussmaul sign > distension of the jugular veins during inspiration (due to elevated venous pressure)/. Can also seen in patients with constrictive pericarditis, restrictive cardiomegaly, RV infarction and tricuspid stenosis. Anxiety Disorder Nausea Anxious Sweating Dizziness Palpitations SOB Loss of consciousness GERD Cough Regurgitation Diet Dysphagia Odynophagia Dyspepsia Blenching Bloating Halitosis Nausea Dental erosion Bronchospasm Any past h. pylori infections. Oesophageal perforation Vomiting and/or retching Severe retrosternal pain Subcutaneous or mediastinal emphysema Dyspnoea Tachypnoea Tachycardia Signs of sepsis Community acquired pneumonia Cough Fever Nausea SOB Herpes zoster Aortic aneurysm Costochondritis Worse on movement