Causes of post covid chest pain and how to manage in a remote setting where ECG is not available?

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Dear dr Ajeet Pal Singh You asked about causes of chest pain in post covid pt 1 mostly seen is ischimia or myocarditis may or may not be a/w pericarditis or pericardial effusion You can take simple xray chest if available or routine lab investigations if can be done if nothing is available and you need to treat simply on presumption we can give emperical treatment safely Like aspirin in loading doses Anticoagulants like revoruxiban or acitrom whichever available Antiplatelets clopidogril in loading doses Diuretics torsamide or lasix There is no harm in giving these medicines as these are all ready given to all most all pts of covid during hospitalization Only thing keep under your observation or followup with facility of oxygen sos required Second possibility is pulmonary Like oedema or embolism or infarct or could be due to ILD/fibrosis All these can easily be differentiated clinically with a/w relevent clinical signs and can be attended accordingly Lastly musculoskeletal reasons can be given NSAIDs and muscle relaxants as per need Keep followup

Thanx dr Pushkar ji Bhomia
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In rural setup it is very hard or probably impossible to diagnose and treat post covid heart pain. You simply prescribe analgesic and refer to higher centre for assessment and treatment . causes are discussed above by colleagues. Even maharashtra govt has started post covid care centre to deal with complications after covid recovery mostly cardiac.

Thanks Dr Pushkar Bhomia
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POSSIBLE. CAUSES... 1. FUNGAL. LUNG. INFECTION 2. COSTOCHONDRITIS SECONDARY. TO.... POST. COVID. FIBROSIS 3. G. E. R. D / GASTRITIS 4. ISCHAEMIC NEEDS ALL. ..BASIC. EVALUATION

POST COVID CHEST PAIN .. ? CARDIAC CAUSES .. ? PULMONARY CAUSES .. NEED'S.. ECG STUDY.. X-RAY STUDY..

Tnx Dr Ashok Leel sir
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Can be myocardial infarction Myocardial ischemia

Better to send the patient to tertiary care center for work up cardiac etiology.

Stop smoking. If you smoke, quit. ... Choose good nutrition. A healthy diet is one of the best weapons you have to fight cardiovascular disease. ... High blood cholesterol. ... Lower high blood pressure. ... Be physically active every day. ... Aim for a healthy weight. ... Manage diabetes. ... Reduce stress. It can feel like uncomfortable pressure, squeezing, fullness or pain. Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath. ECG and X-rays .. study.

Chest pain can be caused by ischaemia Use portable ECG machine for doing ECG Diagnosis is important

Costochondritis, Local muscular, Pericarditis or MI, Esophagitis, DU referred pain. Aspirin tab 12 hrly, Tab.rabiprazole 20mg 12 hrly

We have to find it's either cardiac or non cardiac and manage accordingly. If pain is after exertion,radiating to limbs can correlate with cardiac...if pain during breathing or due to oesophagitis which is retrosternal in origin..can be helpful

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