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.