REGIONAL COOPERATIVE CARE PARTNERSHIP
STATION OUTHOUSE OUTREACH TRAINING
Pneumonia v. Chest Pain
Objective/Goal: Relay pathology/signs and symptoms for help in differential diagnosis
considering the similarities between the two conditions and enhance field personnel
knowledge in recognition of PNA v. Cardiac Chest Pain
Definition:
1. Pneumonia- Collection of related respiratory diseases (viral, bacterial, fungal) caused by
infectious agents invading the lung tissue.
2. Cardiac Chest Pain (CCP)- Collection of related cardiac problems affecting the
efficiency/ability of the heart to pump blood. Examples- partially or totally occluded
coronary arteries
Signs/Symptoms CCP: Diaphoresis, dyspnea with clear lungs(normally), nausea &
vomiting, dizzy, tachycardia (unless controlled by meds,) feeling of doom, EKG changes if
injury or infarct occurring, chest pain of all descriptions
Signs/Symptoms PNA: Diaphoresis associated with fever, chills, general weakness, deep
productive cough yellow or brown sputum, tachypnea with associated dyspnea,
tachycardia, (rales, rhonchi, wheezes) plus pleuritic chest pain defined many times as
sharp or tearing in a specific spot.
Treatments: Both signs/symptoms have several similarities and can over lap, causing the
caregiver to treat regardless of the etiology.
1. 02 via nasal canula or non-rebreather mask depending on the patients needs, 02 sat,
EKG and 12 lead.
2. For CCP: 0.4 mg Nitro, Paste, 162 ASA, MS as needed.
3. For PNA: same as number 1, with cooling measures, CPAP when indicated, possibly
breathing treatment dependent on lung sounds, ETCO2 wave form of shark fin or step
up, BVM/ ETT if severe.
Treatment outcome correctly diagnosed:
1. CCP: Reduced pain and myocardial O2 demand.
2. PNA: Relief of dyspnea, with increased O2 supply reduction in pain, and feeling less
feverish with cooling measures
Treatment outcome if misdiagnosed:
1. CCP: Reduced pain and myocardial O2 demand.
2. PNA: Potential hypotension with extended ED and hospital stays.