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Review of Clinical Signs Review Questions

Chest Pain: Differentiating Cardiac from Noncardiac Causes

Author: Bernard Karnath MD

1. A 50-year-old man presents with complaints of exertional chest pain. The pain is substernal in location and is described as a pressure-like sensation that radiates down his left arm with associated dyspnea on exertion. What is the most likely etiology of this patient’s chest pain?

  1. Costochondritis
  2. Ischemic heart disease
  3. Pulmonary embolism
  4. Reflux esophagitis
Click here to compare your answer.


2. A 30-year-old woman presents with complaints of substernal chest pain. The episodes typically occur immediately after swallowing cold liquids. She denies any associated dyspnea. What is the most likely etiology of this patient’s chest pain?

  1. Costochondritis
  2. Esophageal spasm
  3. Ischemic heart disease
  4. Pulmonary embolism
Click here to compare your answer.


3. A 20-year-old man presents with acute onset of chest pain and dyspnea. The chest pain is located in the right hemithorax and is sharp in nature. Physical examination reveals significantly diminished breath sounds in the right hemithorax with hyperresonance to percussion. What is the most likely etiology of this patient’s chest pain?

  1. Costochondritis
  2. Esophageal spasm
  3. Pneumothorax
  4. Pulmonary embolism
Click here to compare your answer.


4. A 40-year-old woman presents with a complaint of chest pain. The chest pain is sharp in nature and worsens with movement of her upper torso. Physical examination reveals reproducible chest pain on palpation of the sternum. What is the most likely etiology of this patient’s chest pain?

  1. Costochondritis
  2. Esophageal spasm
  3. Mitral valve prolapse
  4. Pneumothorax
Click here to compare your answer.


5. A 50-year-old man presents with complaints of chest pain and fever. The pain is not associated with exertion and is alleviated somewhat by sitting up and leaning forward. The patient states that he had a recent upper respiratory infection last week. Physical examination reveals a friction rub on cardiac auscultation. What is the most likely etiology of this patient’s chest pain?

  1. Costochondritis
  2. Ischemic heart disease
  3. Pericarditis
  4. Reflux esophagitis
Click here to compare your answer.



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