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GLOSSARY OF TERMS These nine diseases are covered in the Acute Chest Pain Tutorial. Angina Symptoms related to reduced oxygen supply to heart muscle Myocardial Infarction “Heart attack”, interrupted blood supply to a part of the heart Pericarditis Inflammation of the pericardium (outer sac-like covering of the heart) Pneumothorax Accumulation of air or gas between the parietal and visceral pleurae Pulmonary Embolus blockage of the pulmonary artery Thoracic Aortic Dissection tearing of the intimal layer of the aorta wall Upper GI chest symptoms related to the gastro intestinal system (esophagus, stomach, etc.) Musculoskeletal non-cardiac chest pain due to fibromyositis (muscle inflammation) Pneumonia microbial infection of one or both lungs This list of terms used in the Chest Pain Diagnosis tutorial is provided for your convenience. The terms are listed in alphabetical order. Feel free to refer to it whenever you need, during the “measures” (tests) or during the tutorial. Acute rapid onset, brief, not prolonged, sometimes used to mean “severe” Angina symptoms related to reduced oxygen supply to heart muscle Anorexia diminished appetite, aversion to food Anterior Infarction infarction affecting the front surface of the heart Aortic Regurgitation backflow of blood through an incompetent aortic valve (of the heart) Apical relating to the apex of the heart (or other structure) Apical impulse action potentials conducted by nerve fibers at the apex of the heart Arrhythmia loss or abnormality of rhythm, in reference to the heart Atherosclerotic Plaque irregularly distributed fat deposits in large and medium-sized arteries Biomarker something that is measured to indicate the presence of a particular disease or pathologic process Bleb acquired lung cyst, usually in the apex (top) of the lung, common cause of pneumothorax Bradycardia slow heart rate Breath Sounds sound of breathing, heard using a stethoscope Cardiac Cycle a complete round of systole and diastole Cardiac Output the amount of blood ejected/pumped out by the heart in a unit of time Carotid Pulse pulse obtained by palpating the carotid artery (neck pulse) Congestive Heart Failure a condition in which the heart cannot supply enough blood to the body’s organs Contralateral relating to the opposite side Coronary artery supplying the muscle of the heart Costochondral Junction where ribs meet cartilage, near the breast bone Creatine Kinase an enzyme that is released following damage to muscle Cyanosis bluish skin tone due to insufficient oxygen in the blood Deep Vein Thrombosis clots formed in the deep veins, usually in the legs Dermal relating to the skin Diabetes Mellitus chronic disorder in which carbohydrate utilization is impaired due to a deficiency of insulin Diaphoresis perspiration, sweating Diaphragm (of Stethoscope) part of the stethoscope that is pressed to skin Diastolic/Diastole period of time when the heart is relaxed after contraction; atrial or ventricular diastole Distal situated away from point of origin or point of reference Dysphagia difficulty swallowing Dyspnea difficulty breathing Edema accumulation of fluid in cells, or between cells Effusion escape of fluid from blood vessels or lymphatics into an organ or cavity Electrocardiogram graph of the heart’s action current, measured in voltage over time Epicardium outer layer of the heart, inner layer of the pericardium Epigastric upper abdomen Etiology cause of disease, mode of operation Expiration breathing out Extremity arms, legs Friction Rub sound heard using a stethoscope, made by the rubbing of two surfaces Gallop abnormal heart sound, involving a third or fourth heart sound (normal: S 1 and S2 only) Heart sound sound of heart valves opening and closing, heard using a stethoscope Hematemesis bloody vomit Hematoma abnormal collection of blood that is confined to a space, tissue, or organ Hematuria blood in urine Hemithorax one side of the thorax/chest Hemodynamic relating to the physical aspects of blood circulation Hemianesthesia loss of sensation of one vertical half of the body Hemiplegia paralysis of one vertical half of the body Hemoptysis coughing up blood Hyperresonance increased/exaggerated sound upon percussion of an area of the body that can vibrate freely Hypertension elevated blood pressure Hypotension low blood pressure Hypoxemia low blood oxygen Hypoxia low oxygen in gases, blood, or tissues Infarction sudden insufficiency of blood supply due to thrombi, pressure, etc.; results in necrosis Inferior Infarction an infarction affecting the lower surface of the heart Inflammation the body’s reaction to infection, irritation, or injury; characterized by redness, heat, swelling, pain Inspiration breathing in Interscapular relating to a location between the two scapulae (shoulder blades) on the back Intimal relating to the innermost layer of the wall of blood vessels Ischemia restriction of blood supply with resultant damage of tissue Lateral on the side, farther from the midline Left Atrium chamber of the heart that receives oxygenated blood from the lungs Left Ventricle chamber of the heart that pumps oxygenated blood to the body Lumen the space in the interior of a tubular structure (such as an artery) Mediastinum middle/median portion of the thorax, containing all structures and organs except the lungs Mitral Regurgitation back flow of blood into the left ventricle due to an incompetent mitral valve Murmur a soft irregular sound heard by stethoscope, due to turbulent blood flow Musculoskeletal relating to the muscles or bones of the body Myalgia muscle pain Mycocardial Infarction “heart attack,” blood supply to a part of the heart in interrupted Myocardium/Myocardial muscular tissue of the heart Neck Vein Distention stretching of neck vein, due to increased blood volume in vein Necrosis accidental/pathologic death of cells or part of organ, irreversible damage Neoplastic relating to the abnormal or cancerous growth of cells of a tissue or organ Nitroglycerin a drug used to treat heart conditions, it works by dilating blood vessels Non-productive Cough a cough that is dry and void of sputum Occlusion blockage Odynophagia painful swallowing Pallor paleness, usually referring to the skin Palpation/Palpate/Palpable during physical examination, using hands to feel various areas of the body Papillary Muscle within the heart, limits movement of tricuspid and mitral valves, resists back flow pressure Paraplegia paralysis of the lower half of the body Parietal Pleura layer of pleura forming the outer boundary of the pleural space Percussion during physical examination, tapping the body surface to determine density of structure below Perfusion flow of blood to tissue Pericarditis inflammation of the pericardium (outer sac-like covering of the heart) Pericardium outer sac-like covering of the heart, double layered with pericardial fluid between layers Pleural Space area or cavity between the two-layered covering (or pleurae) of the lungs Pleuritic Chest Pain pain involving the two-layered covering (or pleurae) of the lungs Pneumothorax presence of air in the pleural space Posterior Horn (of Spinal Cord) area of the spinal cord that receives sensory information from the body Posterior Thoracic relating to the posterior portion of the thorax Postirradiation following exposure to radiation Precordial/Precordium portion of the body over the heart and lower chest Prodromal relating to an early symptom of a disease that predicts further development of the disease Pulmonary relating to the lungs Pulmonary Embolism blockage of the pulmonary artery or any of its branches by fat, air, tumor cells, etc. Pulse Pressure the change in blood pressure during contraction of the heart Radiation (of pain) spreading of pain to other parts of body other than origin Rales during physical examination, abnormal crackling noises of the lungs heard by stethoscope Referred Pain pain experienced in an area different from the area of injury Retrosternal posterior to/behind the sternum Right Atrium the chamber of the heart that receives deoxygenated (venous) blood from the body Right Heart Failure a change in the structure and function of the right ventricle Right Ventricle the chamber of the heart that pumps deoxygenated blood to the lungs S4 (S1, S2, S3) symbols representing the heart sounds Serum fluid portion of blood after removing clotting factors and blood cells Shock a state of inadequate blood flow to vital organs and tissues of the body Sternal Border the lateral border(s) of the sternum Sternum breast bone Stroke Volume the volume of blood ejected by the left ventricle of the heart during one contraction Substernal deep to or behind the sternum Supine lying down face up Syncope loss of consciousness Systolic/Systole contraction of the heart (especially the ventricles) that drives blood out to lungs and body Tachycardia increased heart rate Tachypnea increased breathing rate Tamponade abnormal fluid collection between the heart and pericardial sac, impedes expansion of heart chambers Thoracic Aortic Dissection tearing of the wall of the aorta Thorax upper part of the trunk, between the neck and abdomen, “chest” Thromboembolism blockage of blood vessel due to a thrombus Thrombosis clotting within a blood vessel that may or may not result in a blockage, formation of a thrombus Thrombus/Thrombi blood clot/blood clots Trapezius muscle of shoulder and back Tricuspid Regurgitation backflow of blood into the right atrium through an incompetent tricuspid valve Troponin a protein that plays a key role in muscle contraction Tuberculous relating to or affected by tuberculosis Umbilicus belly button Unilateral on the same side Uremic toxic condition resulting from kidney failure, presence of urea in the blood Venous Return deoxygenated blood return to the heart Ventricle lower chamber of the heart, responsible for pumping blood out of the heart; left or right ventricle Visceral relating to the hollow organs (heart, lungs, blood vessels, etc.) Visceral Pleura layer of pleura forming the inner boundary of the pleura space Wheezes during physical examination, a coarse, whistling sound heard from lungs by a stethoscope Xiphoid the lowermost point of the sternum or breast bone