What could my symptoms mean?
Tell us what you're feeling and see what your body might be saying — and what to ask next.
Maldek · Symptoms · rev · fwd
Chest Pain and ACS Triage
Chest pain triage is about the sickest things you cannot let die: ST-elevation myocardial infarction (heart attack with big damage), non-ST-elevation myocardial infarction (heart attack with smaller damage), unstable angina (chest pain that is getting worse), aortic dissection (tear in the big artery), PE (blood clot in lung), tamponade (fluid squeezing the heart), tension pneumothorax (collapsed lung pushing heart), esophageal rupture (torn food tube). The patient story, an EKG in ten minutes, and a risk score tell you what to do.
Symptoms · forward + reverse · what + why
Forward: the diagnosis predicts the findings. Reverse: the findings reveal the physiology.
Forward · expected findings + mechanism link
- 1
You may see pressure under the breastbone with a history of exercise making it worse and sweating
why · Sometimes coronary blood flow gets blocked partly or all the way.
- 2
Ripping or tearing pain to the back means the aorta is torn
why · Sometimes coronary blood flow gets blocked partly or all the way.
- 3
Sharp pain that hurts to breathe with low oxygen and fast heart rate means blood clot in the lung
why · Sometimes coronary blood flow gets blocked partly or all the way.
- 4
Sudden sharp pain with no breath sounds means collapsed lung
why · Sometimes coronary blood flow gets blocked partly or all the way.
- 5
Sharp pain that changes with position and a scratchy sound means the heart sac is inflamed
why · Sometimes coronary blood flow gets blocked partly or all the way.
- 6
Each of these findings ties back to ischemic chest pain feels like pressure and happens when you move — they are not a random checklist
why · Sometimes coronary blood flow gets blocked partly or all the way.
- 7
At the bedside, your job is to spot the pattern first, then check the broken part
why · Sometimes coronary blood flow gets blocked partly or all the way.
- 8
Does this problem match the upstream break you think it is?
why · Sometimes coronary blood flow gets blocked partly or all the way.
Deterioration arc · if untreated
- ↓ 1.
Sometimes coronary blood flow gets blocked partly or all the way.
This is where the trouble starts.
- ↓ 2.
Vital signs can look good while the body is trying hard to cope. The job is to see the bad crash point coming.
If compensation fails, organ injury is next.
- ↓ 3.
Because the body is trying to keep safe the most important things.
Treatment is aimed at the broken step.
⚠ Red flags · escalate immediately
- •
The body keeps vital signs steady for a while
Stop and escalate — the patient is moving past compensation.
- •
That is the dangerous middle, because it lets the team miss where the patient really is on the curve
Stop and escalate — the patient is moving past compensation.
- •
The crash point to watch for is: The big mistake is missing an aorta tear
Stop and escalate — the patient is moving past compensation.
- •
Mortality climbs 1 percent per hour if you miss it
Stop and escalate — the patient is moving past compensation.
Reverse · findings → physiology chain
- 1
You may see pressure under the breastbone with a history of exercise making it worse and sweating
Sometimes coronary blood flow gets blocked partly or all the way.
- 2
Ripping or tearing pain to the back means the aorta is torn
Sometimes coronary blood flow gets blocked partly or all the way.
- 3
Sharp pain that hurts to breathe with low oxygen and fast heart rate means blood clot in the lung
Sometimes coronary blood flow gets blocked partly or all the way.