ANSWER
Title Page: Differential Diagnosis of Chest Pain
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Overview
A thorough evaluation and differential diagnosis are necessary for chest discomfort, a frequent and possibly fatal symptom. A number of illnesses may be the cause of it, including cardiovascular, gastrointestinal, musculoskeletal, and pulmonary disorders. Since care and treatment differ greatly based on the underlying cause, an accurate diagnosis is essential. This essay will examine the three differential diagnoses of pulmonary embolism (PE), gastroesophageal reflux disease (GERD), and acute coronary syndrome (ACS) that may be linked to chest pain. The presentation, diagnosis, and treatment of these disorders in clinical settings will be covered. Healthcare professionals can enhance patient outcomes by making prompt, appropriate judgments when they have a thorough understanding of these illnesses.
ACS, or acute coronary syndrome
The phrase “acute coronary syndrome” (ACS) refers to a group of illnesses, such as unstable angina, NSTEMI, and STEMI, that are linked to abruptly decreased cardiac blood flow. Chest pain or discomfort, which can be characterized as pressure, tightness, or heaviness, is usually part of the clinical presentation. Breathlessness, diaphoresis, and nausea may accompany the discomfort, which frequently radiates to the arm, jaw, or back. Hypertension, diabetes, smoking, hyperlipidemia, and a family history of heart disease are risk factors for ACS.
ECG abnormalities including ST-segment elevation or depression, as well as measurements of cardiac biomarkers like troponin and creatine kinase-MB, are used to confirm the diagnosis. Aspirin, beta-blockers, anticoagulants, and, depending on the severity of the illness, thrombolytic therapy or angioplasty are all part of immediate management (Morrow et al., 2019). To evaluate heart function and rule out issues like heart failure, echocardiography can also be utilized.
GERD, or gastroesophageal reflux disease
Heartburn, regurgitation, and chest pain are some of the symptoms of gastroesophageal reflux disease (GERD), a disorder where stomach acid or bile irritates the esophagus. Angina might be mistaken for GERD-related chest pain, which could result in a misdiagnosis if not thoroughly examined. Usually described as a burning sensation in the chest, the pain usually happens while lying down or after meals.
Although upper gastrointestinal endoscopy and 24-hour pH monitoring can be utilized for confirmation in refractory instances, the diagnosis of GERD is primarily made clinically. Proton pump inhibitors (PPIs) like omeprazole, H2 receptor antagonists, and lifestyle modifications like cutting back on trigger foods, raising the head of the bed while you sleep are all part of the treatment. For symptom treatment, over-the-counter antacids might be utilized (Gonzalez & Wadhwa, 2020).
Embolism of the lungs (PE)
When a blood clot, which frequently originates from deep vein thrombosis (DVT) in the legs, moves to the lungs and blocks a pulmonary artery, it is known as a pulmonary embolism (PE). Tachypnea, dyspnea, and abrupt start of pleuritic chest discomfort are the hallmarks of PE. Deep breathing may make the pain worse, and other symptoms including cough, hemoptysis, and tachycardia are frequently present as well.
The gold standard for identifying PE is CT pulmonary angiography, which is used to confirm the diagnosis. If CT is not available, a ventilation-perfusion (V/Q) scan is used. Although it is not specific, D-dimer testing is frequently used to rule out PE. Thrombolytics or surgical embolectomy may be necessary in extreme situations, and management entails anticoagulation medication with heparin or warfarin (Kabrhel et al., 2021).
Studies That Back Up the Differential Diagnoses
In their discussion of the value of early diagnosis and treatment for acute coronary syndrome, Morrow, D. A., et al. (2019) highlight the usefulness of biomarkers and ECG in confirming ACS, which is consistent with the management techniques currently employed in clinical practice (Morrow et al., 2019).
In their thorough review of GERD treatments, Gonzalez, R., & Wadhwa, S. (2020) present specific treatment guidelines and diagnostic techniques for acid reflux-related chest discomfort.
In order to lower the fatality rates linked to PE, Kabrhel, C., et al. (2021) describe diagnostic strategies for the condition and go over the use of imaging methods and anticoagulation in pulmonary embolism management (Kabrhel et al., 2021).
In conclusion
A thorough differential diagnosis is necessary for appropriate therapy because chest pain can be a sign of many different diseases. In clinical practice, pulmonary embolism, gastroesophageal reflux disease, and acute coronary syndrome are the most frequent causes of chest pain. A comprehensive patient history, clinical examination, and the appropriate application of diagnostic tests, including imaging, endoscopy, blood tests, and ECG, are all necessary for an accurate diagnosis. Every illness has a different approach to care, involving both non-pharmacological and pharmaceutical methods. Improving patient outcomes, especially in life-threatening illnesses like ACS and PE, requires early intervention and evidence-based treatment.
Citations
Wadhwa, S., and Gonzalez, R. (2020). Diagnostic and therapeutic approaches for gastroesophageal reflux disease. Clinical Gastroenterology Journal, 54(6), 479–485. 10.1097/MCG.0000000000001371 https://doi.org
C. Kabrhel and associates (2021). The diagnosis and treatment of pulmonary embolism. 203(8), 991-1000, American Journal of Respiratory and Critical Care Medicine. 10.1164/rccm.202101-0244OC at https://doi.org
D. A. Morrow and associates (2019). Current methods for diagnosing and treating acute coronary syndrome. American College of Cardiology Journal, 73(3), 312-319. 10.116/j.jacc.2018.09.089 https://doi.org
QUESTION
Research Assignment
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Presentation Content
1.
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Question <bdi></bdi>
Submit a research paper in APA format regarding Chest Pain and Differential Diagnosis. The student is to pick any three (3) differential diagnoses that can be associated with chest pain and their approach in various clinical settings.
Research paper due in week 5.
See Rubric below
Include the following components in your research paper:
1. Title Page
2. Introduction (general)
3. Mention research studies (at least three articles) that validate the information presented in your paper. (Publication date should be no more than five (5) years old).
4. Conclusion
5. References Page
Criteria Rating Points
Exemplary 100 pts
Competent 90 pts
Developing 80 pts
Emerging 70 pts
Not submitted 0 pts
A 20% similarity index for all assignments in Turnitin is preferred. More than 30% is not acceptable. References will be taken into consideration and won’t count toward the percentage.
If you need help with APA style, the link below is provided by the FNU online library under the title “writing studio.”
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