Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

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Wilderness and Rescue Medicine

Chapter 27 Review: Chest Pain

• Chest pain associated with shock, respiratory distress, or the risk factors for myocardial ischemia is serious. • Persistent chest pain after trauma carries the anticipated problems of shock and respiratory distress. • Risk factors for myocardial ischemia include being male over 40 years old, obesity, diabetes, smok- ing, high blood pressure, high cholesterol, and a family history of heart disease. • The field treatment of myocardial ischemia is to give one adult aspirin and oxygen and evacuate emergently. Assist the patient in using nitroglycerin if it has been prescribed for her. • Prolonged ischemia will result in more heart muscle infarction. Rapid evacuation is ideal, even if some exertion is required. • Stable angina is the temporary pain of myocardial ischemia caused by increased demand not met by constricted coronary arteries. The pain resolves with rest. Stable angina is not an emergency if it resolves as expected.