[2] Cardinal Symptoms of Heart Disease Flashcards
Attributes of Pain
O: Other Associated Symptoms P: Provocative/Palliative Q: Quality R: Radiation/Region S: Severity T: Time (Onset, Duration, Frequency)
[Classic Angina vs. Atypical vs. MVP]
Provocative
C: During Effort
A: Spontaneous
M: Spontaneous
[Classic Angina vs. Atypical vs. MVP]
Palliative
C: Rest/Nitrates
A: Nitrates
M: Spontaneous
[Classic Angina vs. Atypical vs. MVP]
Quality
C: Variable
A: Variable
M: Variable
[Classic Angina vs. Atypical vs. MVP]
Radiation
C: Retrosternal
A: Retrosternal
M: Left Anterior
[Classic Angina vs. Atypical vs. MVP]
Severity
C: Mild
A: Mild
M: Mild-Severe
[Classic Angina vs. Atypical vs. MVP]
Timing
C: 1-30 Minutes
A: 1-30 Minutes
M: Minutes - Hours
Recent data shows that Angina attacks should last less than 15-20 minutes
[Classic Angina vs. Atypical vs. MVP]
Other Factors
C: Risk Factors
A: Also w/ CSAP
M: Young Female
When does Variant Angina? or Vasospastic Angina occur?
What is typical of it?
Occurs at Rest
ST Segment Elevation
(Typical myocardial problems cause ST Segment Depression)
What can usually cause Atypical Angina?
Coldness
Diagnose: Patient is a 40F with chest pain on exertion, usually after washing clothes
Upper Extremity Effort
Diagnose: The pain usually occurs during exertion but sometimes at rest or after fatty meals. It is relieved by nitrates or rest, or sometimes by belching…
Multiple Etiologies
Biliary, GERD, Atypical Angina
How do you differentiate Cardiac and Pulmonary Dyspnea?
Cough: Late symptom in Cardiac
Orthopnea: Late symptom in Cardiac
PND: Relieved by standing in Cardiac, Expectorates in Pulmonary
Define: Trepopnea
Difficulty of breathing on one side or another
Define: Platypnea
Dyspnea when upright
How can you alleviate symptoms of Trepopnea?
Lie on the side of the unaffected lung
Diagnose: “Doc, madali po akong mapagod..”
(Easy Fatigue vs. Exertional Dyspnea)
Define: Heart Palpitations
Being aware of your heartbeat
Diagnose: 74F Bilateral Ankle Swelling for the past month, she can hardly walk
Ankle Arthritis
Edemas are not painful
What concentration cause cyanosis?
Normal
Met-Hb
Sulf-Hb
Normal: 5g/dL
Met-Hb: 1.5g/dL
Sulf-Hb: 0.5g/dL
What causes Central Cyanosis?
Arterial Desaturation Centrally
What causes Peripheral Cyanosis?
Vasoconstriction in the Cold
Venostasis
General peripheral problems
Define: Toes were cyanotic but her fingers were not?
Reversed Patent Ductus Arteriosus
Blood goes from right-left instead of the usual way around due to Pulmonary Hypertrophy over time
Define: Syncope
Sudden transient loss of consciousness with no neurologic deficit
Define: Stokes-Adams Syncope
Sudden cessation of cardiac function and effective CO and complete heart block causing loss of consciousness
What is being tested when the doctor asks “What level of effort triggers the pain?”?
a. provocative
b. quality
c. palliative
d. region
e. associated symptoms
(c/o Leland Lukban)
A
Under Canadian cardiovascular grading of angina: Angina with strenuous or rapid or prolonged exertion at work or recreation.
a. grade 1
b. grade 2
c. grade 3
d. grade 4
(c/o Leland Lukban)
A
Region where esophageal non-cardiac associated chest pain is usually observed
a. Retrosternal
b. Left anterior
c. Substernal
d. midclavicular
(c/o Leland Lukban)
C
Which one of these fall under Functional non-cardiac associated chest pain?
a. Tietze’s syndrome
b. Da Costa’s syndrome
c. Prinzemetal’s Angina
d. Kobayashi’s Syndrome
(c/o Leland Lukban)
B
Referred to as a supply type of angina.
a. Classic Angina
b. Atypical Angina
c. Mitral valve prolapse Angina
d. Esophageal Angina
(c/o Leland Lukban)
B
This causes Descending Edema
Renal Cause
This causes Centrifugal Edema
Hepatic Cause
This causes Ascending Edema
Cardiac/Pulmonary Cause
