APPROACH TO PATIENT WITH CARDIOVASCULAR DISEASE Flashcards by Emmanuel Quist

Name 13 symptoms of Cardiovascular Diseases

Dyspnoea
Cough with or without sputum production
Pedal swelling
Right hypochodrial pain from an enlarging liver
Abdominal distension from an enlarging liver and/or ascites
Anorexia
Fullness after taking small amount of food
Palpitation
Dizziness
Syncope
Chestpain
Fatigue
Intermittent claudication

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What is dyspnoea?

Shortness of breath

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Right hypochondrial pain as a symptom of cardiovascular disease could be caused by ?

Enlarging liver

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Abdominal distension as a symptom of cardiovascular disease could be caused by ?

enlarging liver and/or ascites

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What is Palpitation?

awareness of the heart beat

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What is Syncope?

It is fainting or passing out and it is caused by a temporary drop in the amount of blood that flows to the brain

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What is intermittent claudication?

pain caused by too little blood flow to muscles during exercise

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What are the 3 types on dyspnoea ?

Dyspnoea on exertion
Orthopnoea
Paroxysmal nocturnal dyspnoea

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What is Orthopnea?

shortness of breath or difficulty breathing when you’re lying down

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What is Paroxysmal nocturnal dyspnea (PND) ?

is a condition that triggers sudden shortness of breath during sleep. This difficulty in breathing can cause a person to wake up gasping for air.

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Name the NYHA classification of the functional status of patients with heart diseases

NYHA I
NYHA II
NYHA III
NYHA IV

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Nature of NYHA I

No dyspnoea on physical activity

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Nature of NYHA II

Dyspnoea on extra-ordinary activities

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Nature of NYHA III

Dyspnoea on ordinary activities

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Nature of NYHA IV

Dyspnoea at rest

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NYHA stands for?

New York Heart Association

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Physical examination of the CVS

General examination 
Examining the pulses 
Measuring the blood pressure 
Jugular venous blood pressure 
Position of the apex beat 
Palpation of the precordium 
Auscultation of the heart 
Examining the lungs and abdomen

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3 cardinal areas where Palpitations can be felt

Neck, Chest or Epigastrium

What are the four stages of clubbing

Stage 1- Increased sponginess of the nail fold

Stage 2- Obliteration of the angle between the nail and the nail fold

Stage 3- Increased convexity of the nail longitudinally and transversely

Stage 4- Bulbous swelling of the distal end of the finger

What is Angina?

Chest pain caused by reduced blood flow to the heart.

What is Myocardial infarction/Heart Attack?

Damage to heart muscle caused by blockage or decreased blood flow to the heart muscle.

What is the difference between heart attack and cardiac arrest?

Heart attack/myocardial infarction is the damage to heart muscle caused by blockage or decreased blood flow to the heart muscle whiles Cardiac arrest is the failure of the heart to pump blood due to the disruption of the heart’s electrical conduction system.

Heart attack is also known as?

Myocardial infarction

What is Xanthoma?

Raised yellow lesions that are caused by build-up of lipids beneath the skin.

Where can the 1st heart sound be heard ?

Mitral area (5th intercostal space in the mid-clavicular line)

In which group of people is the 3rd heart sound considered pathologic?

Older people (40+)

What causes the 3rd heart sound and when is it heard?

It's normally heard at early diastole and is caused by the abrupt tensing of the ventricular wall following rapid diastolic filling

What are Janeway lesions?

Non-tender macular-papular erythematous lesions that are seen on the palm or finger pulps. They are rare

Presence of raised yellow lesions under the skin caused by lipid build-up (I. E. Xanthoma) is indicative of?

Hyperlipidemia

What is the function of the diaphragm of the stethoscope and name a pathological sound it can pick up ?

It is used to pick up high pitched sounds. | pathological sound -- Mitral regurgitation

What does the presence of Osler's nodes indicate?

Infective endocarditis

Janeway lesions are a rare manifestation of?

Bacterial endocarditis

When is the 4th heart sound heard? Explain it's clinical significance

It is heard during late diastole during atrial contraction. It is indicative of heart failure and is abnormal irrespective of age. It is usually associated with reduced ventricular distensibility.

Should a vessel wall be palpable in pulse examination?

What is the implication of a palpable vessel(artery) wall in palpation?

Thickening of the wall or atherosclerosis

What is the usual site for checking a patient's pulse?

Right radial artery

One characteristic of pain due to pericarditis

Relieved by sitting upright and aggravated by lying down

What is proptosis?

Protrusion of the eyeballs(Eyeballs popping out) . | Exophthalmos means the same thing, but is usually used when describing proptosis due to Graves disease.

What is the name given to the condition where the radial and femoral pulses are not equal when both are checked at the same time?

Radio-femoral delay

What is the normal pulse rate in an adult?

60-100 / min

What are the GI causes of clubbing?

1. Inflammatory bowel disease (especially Crohn's) 2. Cirrhosis 3. GI lymphoma 4. Malabsorption, eg coeliac

What is the Jugular Venous Pressure?

The jugular venous pressure (JVP) reflects pressure in the right atrium (central venous pressure)

Pulsatile raised JVP indicates?

Right heart failure

Non-pulsatile raised JVP indicates?

Superior vena caval obstruction

Orthopnea

Due to left heart failure | Or paralysis of the diaphragm(rare)

Ascites usually seen in which conditions?

Heart failure Constrictive pericarditis Endomyocardial fibrosis Liver Cirrhosis