Cardiac History Flashcards
What comprises 80% of all cardiology?
history and physical
Is “chest pain” a good descriptive word when taking a cardiac history for coronary artery disease (CAD)?
NO.
What are good descriptive terms for CAD?
pressure, tightness, gripping-like sensation, elephant sitting on my chest, man-hole cover on my chest
Where do cardiac symptoms start initially?
sub-xiphoid and CAN radiate to the neck, jaw, either arm, and/or to the back
What is angina pectoris?
decreased blood supply (ischemia) to the heart muscle lasting no longer than 20 mins.
With what is angina pectoris associated?
dyspnea, diaphoresis, lightheadedness, nausea, vomiting and circadian rhythm (6-10am to 4-6pm).
What classically brings on angina pectoris?
exertion, anxiety, cold weather, or sex. REMEMBER that relieves within 20 mins.
What specific group of people usually don’t present with chest discomfort from CAD?
Older, middle aged, obese, white women, especially diabetics. Instead they present with dyspnea and develop neuropathy (dullness) to their heart muscle.
Can you have true angina w/o CAD?
YES. Severe hypertension, coronary artery spasm, valvular heart disease, PE, pulmonary hypertension, esophageal spasm
Why can you get chest discomfort and shortness of breath (SOB) when moving around after eating a large meal?
because we shunt blood from our heart to our digestive tract when we eat.
What percentage of angina is due to spasm?
1%
What happens to the fluid when you lie flat?
The fluid returns to the center of your body, because you are removing gravity from the equation, decreasing systemic vascular resistance. This is why older men get up in the middle of the night to pee more.
Why might a person not be able to lie flat?
They state that “it feels like i’m being smothered.” This occurs, again because of the build of of fluid coming back at them, due to left ventricular dysfunction.
What is the most common cause of left ventricular dysfunction (LVD)?
Ischemia
What causes legs to swell (edema)?
Right sided heart failure