The diagnosis of nonanginal chest pain.

Abstract

The term "atypical chest pain" is a wastebasket term that leads physicians to send any patient with chest pain to coronary angiography. In order to avoid this term, we must learn to distinguish atypical angina from nonanginal chest pain before angiography is considered in order to avoid unnecessary invasive procedures. A chest pain is very likely nonanginal if its duration is over 30 minutes or less than 5 seconds, it increases with inspiration, can be brought on with one movement of the trunk or arm, can be brought on by local fingers pressure, or bending forward, or it can be relieved immediately on lying down. There are also many presumptive signs of nonanginal chest pain such as localization with one finger, radiation to the nuchal area, an inframammary primary site, a pain that reaches maximum at the onset, or relief within a few seconds of swallowing food. Cervical root compression pain and esophageal spasm are the greatest mimics of angina since they can both be relieved by nitroglycerin but they have several features which help to rule out angina.

Sweating: A Specific Predictor of ST‐Segment Elevation Myocardial Infarction Among the Symptoms of Acute Coronary Syndrome: Sweating In Myocardial Infarction (SWIMI) Study Group

“…In a meta‐analysis by Chun and McGee and Panju et al, chest‐pain characteristics such as pressure and the like were not enough to be independently useful in establishing a MI diagnosis. Classic duration of pain lasting >30 minutes can be indicative of either an AMI or a nonischemic etiology, like gastroesophageal disease . In a meta‐analysis of 64 studies, chest‐pain duration >30 minutes suggested low likelihood of MI (LR+: 0.1) .…”

Clinico-Demographic Characteristics of Cervical Spondylosis Patients Presented with Chest Pain

“…Expect in the case of obvious nerve root compression, neurologic findings are often absent or nonfocal 16 . A positive spurling maneuver have specificity of 94.0% with cervical nerve root pathology 17 .…”

Angina cervical: relato de caso

“…Em nosso caso, a paciente apresentava dor na região cervical irradiada para MSE, déficit de força muscular e diminuição do reflexo bicipital, o que se encontra de acordo com vários autores. 1,4,10,15,16 O tratamento da AC é cirúrgico. A descompressão cirúrgica pode ser feita por via anterior ou posterior.…”