APPROACH TO PATIENT WITH CARDIOVASCULAR DISEASE Flashcards
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
What is dyspnoea?
Shortness of breath
Right hypochondrial pain as a symptom of cardiovascular disease could be caused by ?
Enlarging liver
Abdominal distension as a symptom of cardiovascular disease could be caused by ?
enlarging liver and/or ascites
What is Palpitation?
awareness of the heart beat
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
What is intermittent claudication?
pain caused by too little blood flow to muscles during exercise
What are the 3 types on dyspnoea ?
- Dyspnoea on exertion
- Orthopnoea
- Paroxysmal nocturnal dyspnoea
What is Orthopnea?
shortness of breath or difficulty breathing when you’re lying down
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.
Name the NYHA classification of the functional status of patients with heart diseases
NYHA I
NYHA II
NYHA III
NYHA IV
Nature of NYHA I
No dyspnoea on physical activity
Nature of NYHA II
Dyspnoea on extra-ordinary activities
Nature of NYHA III
Dyspnoea on ordinary activities
Nature of NYHA IV
Dyspnoea at rest
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
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?
No
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?
- Inflammatory bowel disease (especially Crohn’s)
- Cirrhosis
- GI lymphoma
- 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
