DDx -1. Cardiac MI (thrombolytic indications*- elevated ST segment > 1 mm in 2 or more contiguous leads, < 12 hours of chest pain or discomfort [Class I], > 12 hours of chest pain or discomfort [Class IIb], <75 years old [Class I], <75 years old [Class Ila], BBB and history suggestive of acute MI [Class I]), Angina (stable, unstable), aortic dissection, pericarditis, Dressier's, tamponade, hypertrophic cardiomyopathy (IHSS), aortic stenosis, MVP , myocarditis
2 Pulmonary - PE, pneumothorax, pneumomediastinum, pleurisy, pneumonia, pulmonary HTN
3 GI - esophagitis, GERD, esophageal perforation, esophageal spasm, PUD, indigestion, gastritis, biliary colic, pancreatitis
4 Musculoskeletal - muscle spasm, costochondritis, rib fractures, rib metastases, spinal DJD
5 Other - anxiety, Herpes Zoster, peritonitis
6 Note *REMEMBER CONTRAINDICATIONS