Hi, I’m Liz Rohr: family nurse practitioner, wife, parent, and founder of Real World NP, a continuing education company for new nurse practitioners in primary care.
I’m on a mission to equip and guide new nurse practitioners so they can feel confident and capable through comprehensive, concise, and hyper-relevant educational resources, without the fluff. We’re also here to provide an approachable, supportive community in order to bring about a new generation of healthcare providers who know that they can make an impact & inevitably disrupt the healthcare industry.
Each week you’ll hear a mix of clinical pearls and practice tips, guest interviews with specialists and allied health professionals, and guidance on navigating the role transition from RN to NP. Make sure you subscribe and leave a review so you won’t miss an episode. Plus, you’ll find links to all the episodes, plus extra goodies over at realworldnp.com/podcast.
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Hi, I’m Liz Rohr: family nurse practitioner, wife, parent, and founder of Real World NP, a continuing education company for new nurse practitioners in primary care.
I’m on a mission to equip and guide new nurse practitioners so they can feel confident and capable through comprehensive, concise, and hyper-relevant educational resources, without the fluff. We’re also here to provide an approachable, supportive community in order to bring about a new generation of healthcare providers who know that they can make an impact & inevitably disrupt the healthcare industry.
Each week you’ll hear a mix of clinical pearls and practice tips, guest interviews with specialists and allied health professionals, and guidance on navigating the role transition from RN to NP. Make sure you subscribe and leave a review so you won’t miss an episode. Plus, you’ll find links to all the episodes, plus extra goodies over at realworldnp.com/podcast.
Hosted on Acast. See acast.com/privacy for more information.
In this conversation, Liz Rohr interviews Jennifer Carlquist, a physician assistant with extensive experience in cardiology, who discusses the assessment and management of chest pain.
They covered:
- Assessing cardiac versus noncardiac chest pain
- Assessing risk for MI and when to send patients to the ED or not
- What EKG findings to watch out for, and how to learn more to build your ekg reading confidence (and what’s new!)
- What we can do for patients to assess and manage heart disease risk, including labs and tests to check in primary care (including the coronary calcium score, LPa, and homocysteine)
- How to communicate and collaborate effectively with ER providers
- Further resources to learn if you’re in cardiology or interested in making the switch from primary care
Takeaways
- Consider both cardiac and non-cardiac causes of chest pain, especially in female patients with atypical symptoms.
- Take a detailed history, including risk factors and family history, and be aware of red flags that may indicate a more serious condition.
- Recognize the limitations of certain diagnostic tests, such as EKGs and troponin levels, and consider a CTA with FFR for outpatient testing.
- Collaboration between primary care providers and the ER is crucial, and concise reporting of findings is key to effective communication.
- Differentiating between hyperkalemia T-waves and hyperacute T-waves can be challenging, but hyperkalemia T-waves are pointy and hyperacute T-waves are more blunted and broad-based.
- Inverted T-waves in leads other than AVR and V1, especially if they are symmetric, can indicate the need for urgent evaluation.
- Q-waves can form within an hour of an infarction, and a small Q-wave in lead III without other abnormalities may be a normal finding.
- When learning EKG interpretation, it is important to start with understanding what a normal EKG should look like and then focus on high-risk findings.
- Inflammation is a significant risk factor for heart disease, and non-traditional risk factors such as psoriasis and early menses should be considered.
- Lab tests such as the coronary calcium score, LPa, and homocysteine can provide valuable information in assessing heart disease risk.
- Magnesium supplementation can be beneficial for patients with palpitations and hypertension, but the specific type and dose should be tailored to the individual.
- Primary care providers play a crucial role in assessing heart disease risk and can collaborate with cardiologists to order appropriate tests and make informed decisions.
- The three-day EKG challenge and the Cardiology Fundamentals Mentorship program are valuable resources for learning and advancing in cardiology.
- The importance of fostering a supportive and collaborative environment in healthcare to provide the best care for patients.
For a full transcript and conversation chapters, visit the blog https://www.realworldnp.com/blog/assessing-chest-pain
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