Objectives
By the end of Family Medicine Clerkship, students will be able to:
Preamble: The following objectives apply to chest pain presenting in the ambulatory care setting (ie. not an Emergency department).
1. Conduct a rapid assessment to identify patients requiring emergency care
2. Describe the family physicians role in the stabilization and initial management of patients identified to require emergent care.
3. Conduct a focused history (including cardiac risk factors) and a relevant physical exam
4. Develop a concise differential diagnosis for patients with chest pain including cardiac and non- cardiac causes.
5. Describe the key clinical characteristics of the following chest pain etiologies: angina, embolism, gastroesophageal reflux, costochondritis, anxiety, pneumonia.
Clinical Cards
Microcases
https://cards.ucalgary.ca/deck/358
References
Recommended Resources Addressing the Objectives
Overview of diagnosis and mgmt of acute chest pain in outpatient adults (6 pages)
Objectives covered: All
http://www.aafp.org/afp/2013/0201/p177.html
McConaghy JR, Oza RS. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician 2013 Feb 1;87(3):177-182.
PMID:23418761
Foundational Knowledge
The Calgary Guide – How the five classic cardiac risk factors contribute to atherosclerosis and heart disease
http://calgaryguide.ucalgary.ca/slide.aspx?slide=Atherosclerosis%20-%20Pathogenesis.jpg
Additional Resources
Chest pain top 10 diagnoses in family medicine + quick clinical pearls (1 page)
Objectives covered: 3 and 4
http://www.ncbi.nlm.nih.gov/pubmed/18077756
Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: chest pain. Can Fam Physician 2007 Dec;53(12):2146.
PMID:18077756
Instructional videos on conducting a chest examination
Medical Council of Canada Objectives on chest pain
http://www.mcc.ca/Objectives_Online/objectives.pl?lang=english&loc=obj&id=14-E
(See other references attached)