Last reviewed: 2 Jul 2021
Last updated: 02 Mar 2021

Summary

Definition

History and exam

Key diagnostic factors

  • chest pain
  • dyspnea
  • pallor
  • diaphoresis
  • cardiogenic shock

Other diagnostic factors

  • nausea and/or vomiting
  • dizziness or lightheadedness
  • weakness
  • distressed
  • tachycardia
  • additional heart sounds
  • atypical location or nature of pain
  • reduced consciousness
  • hypotension
  • abnormal breath sounds

Risk factors

  • smoking
  • hypertension
  • diabetes
  • obesity
  • metabolic syndrome
  • physical inactivity
  • dyslipidemia
  • renal insufficiency
  • established coronary artery disease
  • family history of premature coronary artery disease
  • cocaine use
  • male sex
  • advanced age

Diagnostic investigations

1st investigations to order

  • ECG
  • cardiac biomarkers
  • glucose
  • electrolytes, BUN, and creatinine
  • serum lipids
  • chest x-ray
  • coronary angiogram

Treatment algorithm

Contributors

Authors

Mahi L. Ashwath, MD, MBA, FACC, FASE, FSCMR
Mahi L. Ashwath

Director, Cardiac MRI

Clinical Associate Professor of Medicine and Radiology

Division of Cardiology

Department of Internal Medicine

University of Iowa Hospitals and Clinics

University of Iowa Health Care

Iowa

IA

Disclosures

MLA declares that she has no competing interests.

Sanjay Gandhi, MD, MBA, FACC, FAHA, FSCAI

Director, Endovascular Cardiology

Associate Professor of Medicine, Endovascular Cardiology

Case Western Reserve University

Cleveland

OH

Disclosures

SG declares that he serves on the board of Lobesity and is Governor for the Ohio Chapter of the American College of Cardiology.

Acknowledgements

Dr Mahi L. Ashwath and Dr Sanjay Gandhi would like to gratefully acknowledge Dr Thomas Vrobel, a previous contributor to this topic. TV declares that he has no competing interests.

Peer reviewers

Dale Adler, MD, FACC

Vice Chairman of Medicine for Network Development and Strategic Planning

Brigham and Women's Hospital

Boston

MA

Disclosures

DA declares that he has no competing interests.

Deepak L. Bhatt, MD

Associate Professor of Medicine

Department of Cardiovascular Medicine

Cleveland Clinic

OH

Disclosures

DLB declares that he has no competing interests.

Gregory Lip, MD, FRCP, FACC, FESC

Consultant Cardiologist and Professor of Cardiovascular Medicine

University Department of Medicine

City Hospital

Birmingham

UK

Disclosures

GL declares that he has no competing interests.

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