264 Approach to the Patient with Possible Cardiovascular Disease

Question 1

Complete cardiac diagnosis

Answer 1

1. The underlying etiology.
2. The anatomic abnormalities.
3. The physiologic disturbances.
4. Functional disability.

Question 2

New York Heart Association Functional Classification:

Slight limitation of physical activity

Ordinary activity causes symptoms

Answer 2

NYHA Class II

Question 3

New York Heart Association Functional Classification:

Inability to carry out any physical activity without discomfort

Symptoms at rest

Answer 3

NYHA Class IV

Question 4

New York Heart Association Functional Classification:

No limitation of physical activity

No symptoms with ordinary exertion

Answer 4

NYHA Class I

Question 5

New York Heart Association Functional Classification:

Marked limitation of physical activity

Less than ordinary activity causes symptoms

Asymptomatic at rest

Answer 5

NYHA Class III

Question 6

Laboratory tests that can supplement a complete cardiac diagnosis

Answer 6

(1) ECG
(2) noninvasive imaging examinations (chest roentgenogram, echocardiogram, radionuclide imaging, computed tomographic imag- ing, positron emission tomography, and magnetic resonance imaging)
(3) blood tests to assess risk (e.g., lipid determinations, C-reactive protein or cardiac function (e.g., brain natriuretic peptide [BNP]
(4) occasionally specialized invasive examinations (i.e., cardiac catheterization and coronary arteriography
5) genetic tests to identify monogenic cardiac diseases