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Signs and symptoms
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Possible cause
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Pain can be dull, tight, heavy, squeezing
Usually in centre of chest but can be in shoulders, arms, back, neck, jaw. May be
felt on right side
Cool and sweaty, nauseous, short of breath
Pain often occurs with exercise or exertion of any kind (walking, arguing)
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Heart pain — medical consult
Heart attack OR Angina — episodic chest pain
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Severe pain through to the back — may have neurological deficit.
Older person with a history of hypertension —may be complicated by AMI
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Aortic dissection — medical consult
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Sudden onset of unilateral pain
Pain sharp, mostly on deep breathing
May have fast or shallow breathing or short of breath
May have a history of cough or trauma
Reduced breath sounds or chest movement on one side
More common in men 20-40 years, COPD
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Pneumothorax — medical consult
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Fever, cough, shortness of breath
Pain sharp and mostly on deep breathing
Reduced breath sounds, abnormal sounds in lungs — especially on one side
Comes on gradually over hours to days
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Pneumonia/pleurisy
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Sudden sharp unilateral pain, mostly on deep breathing
Shortness of breath
Painful swollen leg, may cough up blood
Consider if — cancer, leg in plaster, pregnant, postnatal, operation in past 2 months,
lot of time sitting or lying (eg older person, confined to bed) long distance car/plane
travel, previous blood clot
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Pulmonary embolus (blood clot in lung) — medical consult
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Burning or sharp pain
Abdominal tenderness, chest or shoulder discomfort
Pain behind breastbone after eating or when lying down
Often in people who drink alcohol, who are obese or pregnant
Always exclude AMI — relief with antacid +/- local anaesthetic does not rule out ischemic heart disease/cardiac
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Reflux
Oesophageal spasm — medical consult
Peptic ulcer
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History of injury
Pain on moving shoulders or upper body and settles when still
Local muscle tenderness
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Muscle pain — medical consult
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| Tenderness to palpation of costochondral joints |
Costochondritis — medical consult
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