Pleuritic Pain (Pleurodynia): Diagnostic Tests

Obligatory medical device diagnostics.

  • Electrocardiogram (ECG; 12-lead ECG; additional right ventricular leads in unstable patients and if 12-lead ECG is unremarkable)-to confirm cardiac ischemia (reduced blood flow to the heart) [see “Stages of myocardial infarction (heart attack) on ECG” below; if ST elevation is detected on ECG, indication for invasive workup in cardiac catheterization laboratoryNote:
    • Benign early repolarization is a prognostically benign normal variant commonly found in younger men.
    • An acute coronary syndrome (AKS or. ACS, acute coronary syndrome; spectrum of cardiovascular disease ranging from unstable angina pectoris (iAP; engl unstable angina, UA; “chest tightness”; (iAP; unstable angina, UA; “chest tightness”; sudden onset of pain in the region of the heart with inconstant symptoms) to the two main forms of myocardial infarction (heart attack), non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI)) cannot be ruled out by a single determination of an ECG and biomarkers (high-sensitivity cardiac troponin T, hs-CTnT). ]
  • X-ray of the thorax (X-ray thorax/chest), in two planes – in cases of suspected pulmonary infection, pleurisy (pleurisy), pneumothorax (collapse of the lung caused by an accumulation of air between the pleura visceralis (lung pleura) and the pleura parietalis (pleura)), rib fracture (rib fracture), etc.

Stages of myocardial infarction on ECG

Stage Description Start/Duration
Stage 0 Excessive T wave (“suffocation T”). Presentable only for a short time at the onset of infarction, therefore usually undetectable
Stage I “fresh stage” Typical ST elevation with monophasic deformity, T positive, R small Q still small Detectable after minutes to hours/up to a week
Intermediate stage Mild ST elevation, T spike negative, Q large, R small. Onset/duration: 1st-10th day; short
Stage II “reactive follow-up stage” ST stretches isoelectric or still slightly elevated; T-negativization and formation of a Q-spike (> 1/4 of R-spike + duration > 0.03 sec. = pardee-Q) Day 3-7/6 months to several years.
Stage III “terminal or scar stage”, “residual findings” Pardee-Q visible; R-loss visible, if applicable. 6 months to persistent