What physical examinations can be done to assess NSTE-ACS?
The physical examination in NSTE-ACS can be normal, but signs of HF should expedite the diagnosis and treatment of Amsterdam et al 2014 AHA/ACC NSTE-ACS Guideline e353 this condition. Acute myocardial ischemia may cause a S4 , a paradoxical splitting of S2 , or a new murmur of mitral regur- gitation due to papillary muscle dysfunction. However, these signs may also exist without NSTE-ACS and thus are nonspe- cific. The coupling of pain on palpation suggesting musculo- skeletal disease or inflammation with a pulsatile abdominal mass suggesting abdominal aortic aneurysm raises concern for nonischemic causes of NSTE-ACS. The physical exami- nation can indicate alternative diagnoses in patients with chest pain, several of which are life threatening.