🫀 Chest Pain Triage — Cardiac vs Non-Cardiac Simulator

Pain Character and Radiation — the First Triage Filter

Placeholder: initial pain descriptors quickly narrow the differential.

• Sudden: Onset pattern (placeholder onset descriptor)
• 5 zones: Radiation sites (placeholder radiation map)
• 20 min: Duration cutoff (placeholder ischemia threshold)
• Yes/No: Positional change (placeholder MSK/GERD clue)

Character and radiation intake

Placeholder: describe pain quality, location, and radiation briefly.

Placeholder: radiation to jaw or back changes urgency fast.

Matching Features Against Myocardial Infarction

Placeholder: crushing pressure plus autonomic signs suggest MI.

• Pressure: Classic quality (placeholder MI descriptor)
• Common: Diaphoresis (placeholder autonomic sign)
• <10 min: ECG priority (placeholder door-to-ECG)
• Serial: Troponin role (placeholder biomarker use)

Cardiac feature checklist

Placeholder: pressure-like pain, exertional trigger, diaphoresis.

Placeholder: ECG within minutes for suspected MI.

Matching Features Against Aortic Dissection

Placeholder: tearing pain radiating to the back is a red flag.

• Tearing: Classic quality (placeholder dissection descriptor)
• Key sign: BP asymmetry (placeholder limb BP diff)
• CT angio: Imaging (placeholder confirmatory test)
• HTN/Marfan: Risk factor (placeholder predisposing factor)

Vascular feature checklist

Placeholder: sudden tearing pain, back radiation, pulse deficit.

Placeholder: pulse or BP asymmetry raises dissection concern.

Matching Features Against Pulmonary Embolism

Placeholder: pleuritic pain with dyspnea and clot risk factors.

• Pleuritic: Classic quality (placeholder PE descriptor)
• Prominent: Dyspnea (placeholder respiratory sign)
• Wells/PERC: Risk score (placeholder scoring tool)
• CTPA: Confirm test (placeholder imaging choice)

Pulmonary feature checklist

Placeholder: pleuritic pain, tachypnea, recent immobility/clot risk.

Placeholder: sudden dyspnea plus pleuritic pain flags PE.

Matching Features Against GERD and Musculoskeletal Pain

Placeholder: sharp, positional, reproducible pain suggests benign cause.

• Sharp: Classic quality (placeholder benign descriptor)
• On palpation: Reproducible (placeholder MSK clue)
• Postprandial: Relation to meals (placeholder GERD clue)
• Improves: Response to antacid (placeholder GERD test)

Non-cardiac feature checklist

Placeholder: positional, reproducible, meal-related pain patterns.

Placeholder: reproducible chest wall tenderness suggests MSK cause.