Approach to the patient with Chest Pain

Determine – What is the type of Problem?

• Chest Pain – Is it Musculoskeletal?
• Chest Pain – Is it Cardiac ?
• What can you assume (if no other complication)?
• Neuromuscular & Strength?
• Endurance?
• Function?

What should you check for?

Ans: ECG / Troponin Trend / Activity Stress Test

Intervention

• Education
• Submaximal Aerobic Exercise – Walking with ECG and Vitals Measurement
• Be mindful of: Criteria for Termination of Exercise

Given the limited PT interventions, there are limited options for outcome measures here. Check out the following section & pages.

Outcome Measures to Consider

Check out Outcome Measures here.

Disposition

Options: Home vs. Rehabilitation ?

Given that the patient was independent, and still tests as independent, patient may go home, unless additional medical intervention complicates the picture.

Documentation of the Assessment & Intervention, including discharge planning & DME

A xx y/o M/F who was admitted w/chest pain & undergoing workup in line with possible ischemic heart disease. There is elevated troponin but serials not yet obtained. Also, ECG is consistent with ischemia but no frank MI noted per ED/medicine notes. For now, we do not find any musculoskeletal reasons for pain. Functional examination is currently devoid of chest pain and is likely related to medical management. There is no immediate issues that we need to address. Consider reconsulting us once medical management is complete and should patient’s functional status change. For now, we will sign off.