MI can be confirmed with ST changes on an EKG and elevated troponin levels (Abraham et al., 2019). GERD will not show ST changes or elevated troponin level. These two diagnoses must be differentiated as soon as possible because an MI is a medical emergency where GERD can usually be treated with over-the-counter medication and does not require emergency medical care within the hospital setting.
Abraham, A. S., Vinson, D. R., & Levis, J. T. (2019). ECG diagnosis: Acute myocardial infarction in a ventricular-paced rhythm. The Permanente journal, (23)19-001. https://doi.org/10.7812/TPP/19-001
Goolsby, M. J. & Grubbs, L. (2019). Cardiac and peripheral vascular systems. In Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses. (4th ed., 187-234). F.A Davis Company.
Cardiovascular disease is the leading cause of death in the United States (Goolsby and Grubbs, 2019). Issues with the cardiovascular systems can impact other body systems and decrease quality of life. As providers, we must recognize the signs and systems of cardiovascular disease to get the patient early treatment. Early detection and interventions can significantly increase the chances of having a positive outcome (Goolsby and Grubbs, 2019). It is essential to perform an accurate health history and physical assessment of the cardiovascular system.
Chest pain is a prevalent symptom that brings many patients into the hospital. However, chest pain alone is not specific enough to make a clear diagnosis. One common diagnosis associated with chest pain is gastroesophageal reflux disease (GERD), and a less common diagnosis associated with chest pain is Myocardial Infarction (MI).
It is essential to utilize the seven attributes of a symptom to differentiate between an MI and GERD. A person with GERD will describe the pain as a burning sensation or pressure in the substernal area (Goolsby and Grubbs, 2019). The pain is worse when lying down and commonly occurs after eating. The person may feel diaphoretic or nauseous (Goolsby and Grubbs, 2019). During an MI, the pain will present as a sudden, sharp pain/ pressure in the substernal region and may radiate to the arm or neck (Goolsby and Grubbs, 2019). The person may be diaphoretic, nauseous, weak, tachycardic, and short of breath (SOB) (Goolsby and Grubbs, 2019). Atypical pain is also seen in an MI; this can include jaw pain, fatigue, indigestion, and upper back pain which is more common in women, the elderly, and patients with diabetes (Goolsby and Grubbs, 2019). A thorough health history, including family history, is also essential.
MI can be confirmed with ST changes on an EKG and elevated troponin levels (Abraham et al., 2019). GERD will not show ST changes or elevated troponin level. These two diagnoses must be differentiated as soon as possible because an MI is a medical emergency where GERD can usually be treated with over-the-counter medication and does not require emergency medical care within the hospital setting.
Abraham, A. S., Vinson, D. R., & Levis, J. T. (2019). ECG diagnosis: Acute myocardial infarction in a ventricular-paced rhythm. The Permanente journal, (23)19-001. https://doi.org/10.7812/TPP/19-001
Goolsby, M. J. & Grubbs, L. (2019). Cardiac and peripheral vascular systems. In Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses. (4th ed., 187-234). F.A Davis Company.
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