List features of the acute, classical presentation.
Acute retrosternal chest pain
Typical: dull, squeezing pressure and/or tightness
Commonly radiates to left chest, arm, shoulder, neck, jaw, and/or epigastrium
Precipitated by exertion or stress
Symptom relief after administration of nitrates is not a diagnostic criterion for cardiac ischemia.
The peak time of occurrence is usually in the morning.
Dyspnea (especially with exertion)
Dizziness, lightheadedness, syncope
What are other, additional findings?
Symptoms of CHF (e.g., orthopnea, pulmonary edema) or cardiogenic shock (e.g., hypotension, tachycardia, cold extremities)
New heart murmur on auscultation (e.g., new S4)
List atypical presentations. When are those more common?
more likely in elderly, diabetic individuals, and women
Stabbing, sharp chest pain
No or minimal chest pain:
Autonomic symptoms (e.g., nausea, diaphoresis)