Introduction

The Chest Pain module aims to to build confidence in students in evaluating a patient in the Emergency department or on the wards in a time effective way.

This module forms part of the Core Curriculum.

• It requires 30 minutes preparation.

• It can be taught in 1 hour

  • However, this topic can be broken down into individual pathologies, or extend for a long as the audience's attention can last.

Teaching approach

As with all modules, familiarise yourself with the NPMT principles.

this session aims to:

• Illustrate the wide scope of differentials for the presentation of chest pain

• Help students develop a structure for approaching potentially urgent clinical cases

• Demonstrate a tailored history taking process and examination for an initial assessment of chest pain

• Explore and identify the key red flags of chest pain

• Identify key early investigations in chest pain evaluation

• Help students feel confident identifying early analgesic and treatment strategies in chest pain

• Assist students in recognising when, how and to whom to escalate cases of chest pain reviews

Tips & Tricks on running an effective session:

• Be as interactive as possible

  • Encourage discussion of cases students have been exposed to, or questions they may have encountered in their reading

  • If you are unsure of the answer to questions, indicate sources that could be consulted by students and strategies to solve this question were you to encounter it on the wards

• Focus on how to approach a patient with chest pain, rather than individual management strategies post diagnosis

• Be sure to emphasise that chest pain and ACS are not synonymous, and consider the possibility of atypical presentations

• Consider the approach with three categories in mind: (1) the working diagnosis, (2) differential diagnoses, (3) life-threatening diagnoses to be excluded.

Here are common pitfalls to avoid:

• Spending too much time on individual pathologies, or the management of conditions post diagnosis

• Focusing on rare pathology

• Going into too much detail on a workup or high level management

From our feedback, the more interactive and ‘put on the spot’ you make the session, the more valuable it will be. Having students think on the spot and share their ideas in a non-threatening environment is key to making the session light-hearted and collaborative so that they can apply what they have learnt at medical school to a clinical patient.

Download Resources:

• Curriculum pack

• Handout to be given mid-point in tutorial to guide discussion.

Other Resources

• Agency for Clinical Innovation: Pathway for Acute Coronary Syndrome Assessment (PACSA)

• MDCalc: Heart Score for Major Cardiac Events

• Life In The Fast Lane: Chest Pain DDx