HeartBurn

HeartBurn

1. DDX For chest pain

   • Cardiac Cause
     • Ischemic
     • Non-ischemic
   • Noncardiac causes
     • Gastroesophageal
       • Reflux esophagitis
       • Esophageal spasm
       • esophageal perforation
       • Gastritis
       • Peptic ulcer disease
         • A break in the lining of the stomach, first part of the small intestine or occasionally the lower esophagus.
           • History taking
             • Investigations
               • Non invasive
                 • Urea breath test
                 • Stool antigen test
                 • Elisa
               • Invasive
                 • Culture
                 • Endoscopy
               • Management
                 • Triple therapy
                   • 2 anti-biotics
                     • Amoxicillin
                     • Clarithromyicn
                   • 1 PPI
                 • Complications
                   • Malt lymphoma
                   • Adenocarcinoma
                 • Prognosis
                   • The earlier the treatment the better the prognosis
       • GERD
         • Signs & symptoms
           • Regurgitation
           • Dysphagia
           • Hoarseness
         • GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach
           • History taking
             • • Investigation
                 • PPI test if failed
                   • Upper endoscopy
                   • 24-hpur esophageal PH study
                   • wireless capsule PH study
                   • Esophageal impedance testing
                 • Management
                   • Complications
                     • Esophageal stricture
                     • Esophageal Ulcer
                     • Barrett's esophagus
                   • Prognosis
                     • The earlier the management the better the prognosis
                   • Pharmacological
                     • PPI
                     • Antacids
                     • Cytoprotective agent
                     • H2 antagonist
                     • Cholinergic antagonist
                   • Non-pharmachological
                     • Lifestyle change
                     • Body wheight reduction
                     • No tight clothes
                     • elivation of the bed-head
     • Pulmonary
       • Pneumothorax
       • Pulmonary embolism
     • Musculoskeletal
       • Costochondritis
       • Rib fracture

2. Causes

   • Food
   • Medication
   • Alcohol
   • smoking
   • obesity
   • Hernia
   • pregnancy

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