Differential diagnosis of chest pain in the open air. Emergency medical care (lecture)

Acute pain syndrome can occur in any person, both at home, at work, and on vacation. It can be experienced by people liable for military service. Everyone (the victim) should be able to help themselves and others. Most often, acute chest pain occurs in cardiovascular diseases: angina pectoris (most often), myocardial infarction, aortic dissection, pulmonary thrombosis. Ischemic heart disease is a myocardial lesion caused by coronary circulation disorders. Coronary artery disease can be of organic and functional genesis. Stenosing atherosclerosis is detected in 95% of patients with coronary artery disease, and a 50–70% reduction in arterial lumen is considered hemodynamically significant. Only 5% of patients have «clean» or slightly changed coronary arteries. It is precisely the coronary artery disease that causes chest pain, and it can be: sudden coronary death, angina pectoris, myocardial infarction, post-infarction cardiosclerosis, heart rhythm disturbances, heart failure. Angina attacks can occur in people of all ages, but more often in middle-aged and older people with physical and mental overload. It is especially dangerous when chest pain (behind the sternum, in the left half of the chest, between the shoulder blades, sometimes in the left jaw) occurs when a person is in an open space and needs to be quickly treated (self-help). This lecture discusses the issues of diagnosing chest pain (angina pectoris) and providing emergency medical care.