chest pain and GERD

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this is a basic question but how do you distinguish between chest pain and pain due to reflux?

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EKG, labs, GI cocktail.....if the cocktail makes the pain go away it was esophageal and not cardiac.

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Specializes in Education, Acute, Med/Surg, Tele, etc.

It is all tests! You can not distinguish on symptoms because, especially women, the symptoms can be way to close!

I was doing a ride along with paramedics...we had this 50 year old female that had crushing chest pain radiating in her jaw and arm. Classic! EKG showed nothing but some mild tachycardia (proably from pain and pressure).

After all the typical questions...we had to go with MI...and well, that is the worse case scenerio so cool! IN the ambulance I asked her if she had had some recent procedures done...I noted a EKG tab on her leg! She said "oh yes, I went and had a gall bladder exam just today (of course that happened to something she forgot to mention..but she was so painful and scared!)....

It seems that it was the air in the gall bladder from the test that was causing the chest pain...and as we drove I found the pain was really in her left scapula (not arm) and she had a painful jaw from gritting her teeth so hard from pain!

BUT...if I hadn't have asked those questions and really got to the bottom line in a very painful and scared patient....it was classic for MI!

I always say..go with the worse case, rule out from there..and that is a docs deal...but my assessment...well that can be soooooooooooo helpful!

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Specializes in Vents, Telemetry, Home Care, Home infusion.

GERD often has other signs and symptoms on questioning:

http://www.aboutgerd.org/characteristics.html

Must do cardiac workup as MI often missed in women.

http://www.ynhh.org/healthlink/cardiac/cardiac_10_02.html

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