Cardiac chest Pain VS Non-Cardiac

[emad]

Hi all ;

Do you have suggesations to differenate between Cardiac chest pain and Non-cardiac ?

Example : I have cardiac patient with left upper limb pain and numbness negated /ruled out by cardialogists cardiac origin of Pain . I am approachng him as Musculoskeletal . The patient believes its cardiac problem !

cheers
Emad

[Jason Silvernail]

If he's been seen by a physician and determined to not have cardiac-based chest pain (eg his cardiac enzymes are normal or did not respond to nitro or EKG normal, etc, etc) then it seems that you've got musculoskeletal chest pain.

See the Five Questions thread for more detail on what to ask...

[nari]

Hi Emad,

In addition to what Jason said, does the pain increase on activity? Has he had a stress test? The accompanying numbness suggests the pain is non-cardiac.
I would continue as you intended, and explain the differences to him. His fear factor might get in the way of resolution, however.
Good luck.

Nari

[emad]

Hi Jason , Thanks Nari ;

After my intial session ,there was 40 % progress which means it is musculoskeletal .the second session was yesterday he reported most pain ddecrease was after he get out forcelly secreations .The objectivity of physicians' tests and investigations is at doubt for me personally , I feel they are asking and performing many tests with no accurate/high reliability . I think they performed for him ECG , and other tests ..if no progress they will refer him for invasive methods... .Cathe terization .

cheers
Emad