Lower throat upper chest discomfort full#
Lower throat upper chest discomfort pro#

Lower throat upper chest discomfort pro#

An N-terminal pro B-type natriuretic peptide test may help focus on the heart for heart failure, or a pericarditis or myocarditis. A D-dimer test may help raise the likelihood of a pulmonary embolus, and a high cholesterol level may make a vascular event (coronary or aortic) more likely.ДЄ high serum glucose or HBA1c level may point towards an infection, ischaemia or even pancreatitis. Liver function tests may help diagnose biliary colic or cholecystitis, an acute hepatitis or hepatic abscess. A creatine kinase level may assist with diagnosis of muscular problems or myocardial damage within the last few days. Creatinine and electrolyte levels may focus the diagnosis to a renal or ureteric problem, or, if the sodium level is low, to possible heart failure.ДЄ serum lipase or amylase test may assist with the diagnosis of pancreatitis or gall stone biliary colic.

Lower throat upper chest discomfort full#

A full blood count can help exclude a gastric bleed or point towards an infection, such as pneumonia or shingles, or pyelonephritis if the white blood cells are raised. A screen of blood tests can be of considerable help with the diagnosis. If the pain is relieved by a glyceryl trinitrate spray, this might assist the diagnosis of cardiac ischaemia, but oesophageal spasm, among other sources of upper abdominal/lower chest pain, can also be relieved by a GTN spray.ДЈ. If the pain lasts less than 10 to 15 minutes, this might suggest ischaemia, but many other causes of chest pain are also transient and repetitive. If there is radiation of pain to the arms or throat, this might suggest an ischaemic origin, but other causes of pain can also radiate, so certainty is not obtained from this feature either. At rest, or when a patient is lying down, it is more likely to be from reflux or gastritis, or to have a musculoskeletal cause, or one of very many alternative causes. If the chest pain is provoked with exercise, it is more likely to be ischaemic. No! Patients who present with upper abdominal/lower chest pain are common, and their symptoms are notoriously difficult for clinicians to accurately diagnose.ДЄ. It is normal, as are most ECGs when patients present with upper abdominal/lower chest pains, particularly if the pains are not ongoing when the ECG is performed.Дў. The ECG shows sinus rhythm, a rate of 63 beats per minute and a normal axis. How could your stress levels potentially be helped?ДЎ. Do you feel vulnerable to a complaint to the HDC in the current healthcare environment?ДЄ.

What Ministry of Health management strategies may be of help?Д§. Could you admit the patient to hospital?Д¦. What imaging tests might help make the diagnosis?ДҐ. What blood tests could be of help in this situation?Д¤.

What features of the history would help distinguish cardiac ischaemic pain from some other cause of upper abdominal/lower chest pain?ДЈ.

Is it easy for a clinician to make the correct diagnosis for a patient with upper abdominal/lower chest pains?ДЄ. The additional fee for the patient is $30.Дў. Nonetheless, you ask your nurse to arrange an ECG for your patient. You accept that there may have been other issues within the HDC decision that you do not fully understand. She has a past history of cigarette smoking, hypertension, type 2 diabetes and ischaemic heart disease, having experienced a heart attack and placement of a coronary stent three years before.ДЄfter a recent continuing medical education meeting, at which you reviewed a case reported to the Office of the Health and Disability Commissioner, you are aware that a colleague has been criticised over several issues, including not performing an electrocardiogram in a similar situation. She does not have the chest pain when she comes to your clinic. It is you who will need to worry about the clinical decision you makeвЂ¦on occasion, you will get this wrongДЄ 64-year-old secretary comes in to discuss her recent tiredness, intermittent upper abdominal/lower chest pains and the stress she is feeling from her work.