Cardiac assessment and differentials Flashcards
What are some cardiovascular causes for chest discomfort?
Angina, MI, Pericarditus and Aortic distension.
What are some other causes for chest discomfort?
MSK pain, Pnemotherax and Oseopharyngeal spasm
What are some cardiovascular causes for breathlessness?
Heart Failure, Valvular disease, PE, Angina and pulmonary hypertension.
What are some other causes for breathlessness?
Anxiety, COPD, Respiratory disease and obesity.
What are some cardiovascular causes for Syncope/ presyncope?
Posteral hypotension, Arrhythmias, aortic stenosis, hypertronic cardiomyopathy (heart muscle becomes thickened).
What are some other causes for Syncope/ presyncope?
Simple faints, epilepsy, anxiety
What does ischemia cause on an ECG?
ST segment depression depression and t wave inversion. Causes repolarisation to occur along an abnormal pathway
What is an infarction?
Where tissue has died
Define a STEMI
Portion of the cardiac muscle that is deprived of coronary artery blood flow long enough that sections of the muscle die.
What are the clinical features of a STEMI
- Central Chest pain described as heavy, squeezing, crushing or tight
- levines sign (unconsciously clenches a fist when describing pain)
- pain radiating to arm, neck or jaw
- palpitations
- feeling of impending doom
- hypotension
- confusion.
- pale, cold or clammy
- ST elevation
What is the management of a STEMI
Aspirin 300mg
GTN 400mcg - check bp before giving
Two pain scores recorded before and after treatment
Analgesia (entonox, paracetamol and morphine)
SATS recorded
What is angina pectoris?
Supply of oxygen to the myocardium is insufflent to meet the demands.
What is the presentation of unstable angina?
Chest pain while at rest
SOB, sweating, nausea, vomiting and palpitations
ECG showing st depression, and or t wave inversions or normal ecg
What are the signs and symptoms of acute dissecting aneurysm of the aorta?
Chest pain
Pain comes on suddenly - ripping, tearing or sharp
ECG changes can mimic an MI
What are the signs and symptoms of expanding and ruptured AAA?
Sudden onset of abdominal or back pain.
Pain is constant and cannot be relieved by changing position.
Keep as flat as possible
What are the signs and symptoms of cocaine toxicity?
Hypertension
Irregular heart beat
Nausea
Agitation
Tremors
Anxiety
Confusion
What is the management for cocaine toxicity?
Diazepam
