2.Signs and Symptoms in CV Medicine

Question 1

What is acute coronary syndrome?

Answer 1

Sudden reduced blood flow to the heart

Question 2

How is chest pain differentiated into being stable angina or an acute coronary syndrome?

Answer 2

Angina can be brought on by exertion and nitroglycerin spray

MI pain is present at rest and is not relieved by nitroglycerin

Question 3

Who is more likely to have silent MIs?

Answer 3

Women

Diabetics

Question 4

Which ions are important in relation to arrhythmias?

Answer 4

K+
Na+
Ca++
Mg++

Question 5

What are the symptoms of MI?

Answer 5

Central, dull, crushing chest pain
Pain radiates to arm, jaw, neck, teeth, back or abdomen
SOB
Fear of dying
Pallor, cold, clammy, nausea, vomiting

Question 6

What is systolic LV failure?

Answer 6

LV is dilated and has reduced contractibility as a result

Question 7

What is diastolic LV failure?

Answer 7

Thick, stiff ventricle walls that have reduced filling capacity

Question 8

What are the symptoms of LV failure?

Answer 8

Causes pulmonary oedema: dyspnoea, orthopnoea, paroxysmal noctural dyspnoea, frothy white cough
Restlessness, confusion, fatigue, dizziness

Question 9

What are the signs of LV failure?

Answer 9

Tachycardia
Reduced oxygen sats
Bibasal crackles and wheeze
Displaced apex beat
Heart sounds s3 and s4

Question 10

What are the causes of RV failure?

Answer 10

LV failure
Cor pulmonale
PE
Pulmonary hypertension

Question 11

What are the symptoms of RV failure?

Answer 11

Blood accumulates in veins: lower limb and abdomen swelling
Anorexia and GI symptoms
Fatigue and weight gain

Question 12

What are the signs of RV failure?

Answer 12

lower limb and sacral odema
Ascites, hepatosplenomegaly
Increased JVP
Additional heart sounds and parasternal heave

Question 13

What are the symptoms of cardiac arrhythmias?

Answer 13

Mostly asymptomatic 
Palpitations
Lightheadedness
Fatigue
Angina
Dyspnoea

Question 14

What are the signs of cardiac arrhythmias?

Answer 14

Brady/tachycardia
Irregular pulse
Syncope
Confusion
Cardiac arrest and sudden death

Question 15

What are the symptoms of aortic stenosis?

Answer 15

Angina
Syncope
Dyspnoea and reduced exercise tolerance
Signs and symptoms of heart failure

Question 16

What are the signs of aortic stenosis?

Answer 16

Low volume slow rising carotid pulse
Single S2, S4
Displaced apex beat

Question 17

What are the symptoms of mitral regurgitation?

Answer 17

Exertional dyspnoea
Fatigue
Signs and symptoms of heart failure

Question 18

What are the signs of mitral regurgitation?

Answer 18

Pansystolic murmur radiating to the axilla

Atrial fibrillation

Question 19

What are the specific findings of cardiogenic shock?

Answer 19

Hypotension and tachycardia
impaired cognition
Skin pale, cool, clammy

Question 20

What are the specific findings of heart failure?

Answer 20

Increased JVP
3rd heart sound
Bibasal crackles
Pulsatile tender liver
Bilateral lower limb oedema

Question 21

What is the specific finding of valvular disease?

Answer 21

Murmurs

Question 22

What are the specific findings of vascular disease?

Answer 22

Carotid bruit
Palpate abdomen for abdominal aorta
Peripheral pulses

Question 23

What is carotid bruit?

Answer 23

Sound heart in carotid arteries due to turbulent flow

Question 24

What is the specific finding of pericardial disease?

Answer 24

Friction rub

Question 25

Describe the murmur seen in aortic stenosis

Answer 25

Ejection murmur at right upper sternal border, radiating to carotids