A Thorough History Gathering and Physical Exam Will Inform Your Working Diagnosis

• Consider potential life threats ​(including Cardiac Ischemia​)​
  • BUT, also consider other potential causes such as Pneumothorax, Dissecting thoracic aorta​
• ABCs and Vital Signs: Are VITAL and can inform the patient's severity​​
  • Is the patient in SHOCK (Hypotension +/- Tachycardia) requiring Load and Go Transport​
• Complete a full history, including ​​
  • SAMPLE​​
  • OPQRST​​
  • Pain Scale

Frequent Reassessments of the Patient are Crucial

• Perform a complete but targeted Physical Exam​ and reassess often. This should include:​
• Chest​
• Lungs ​
• Abdomen​
• Neck​
• Extremities​
• Make sure to reassess your patient for changes in status (cardiac ischemia can be dynamic!) ​
• Changes to pain level, LOA, skin condition, VS​
• Serial ECGs if increased pain (Exception: if STEMI is already identified)

Bottom Line:

Calls for cardiac ischemia can be dynamic. Not only is it important to identify potential cardiac ischemia with thorough assessments, but it is also imperative to identify changes to patient condition through frequent reassessments!

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