Cardiac Pain Flashcards
SOCRATES for cardiac chest pain?
S: Centre of chest O: Sudden onset C: Dull or crushing R: Left arm, neck, jaw A: Nausea, sweating, breathlessness T: 10 mins - 1 hour E: Exertion, cold air, relieved by rest, GTN spray S: Mild to very severe May sometimes present as indigestion
What is the difference between angina and acute coronary syndrome in terms of: 1) Brought on by? 2) Relieved by? 3) Duration? 4) Severity? 5) Associated symptoms?
Angina: 1) Usually brought on by exertion (though unstable angina @ rest) 2) Usually relieved by rest or GTN spray 3) Short time (10-15 mins) 4) Mild-moderated severity 5) Less likely to have severe associated symptoms Acute Coronary Syndrome: 1) Can come on at rest or exertion 2) Not relieved by rest or GTN spray 4) Lasts longer than angina symptoms 4) More severe pain 5) Associated symptoms
What is the difference between stable angina and non-stable angina?
Stable angina occurs predictably. It happens when you exert yourself physically or feel considerable stress. Stable angina doesn’t typically change in frequency and it doesn’t worsen over time. Unstable angina is chest pain that occurs at rest or with exertion or stress.
What are the common presenting symptoms in CVS disease?
Dyspnoea Oedema Palpitations Syncope / pre-syncope
What can respiratory problems can cause chest pain?
Cough, temperature, haemoptysis, risk factors for PE
What GI problems can cause chest pain?
Pain related to eating, reflux, burning, indigestion, swallowing difficulty, vomiting or regurgitation
What musculo-skeletal problems can cause chest pain?
Recent falls, injury, trauma
What psychological problems can cause chest pain?
Anxiety, stress, recent life events
What are the common CVS risk factors to ask about?
- Diabetes - Smoking - Diet and exercise - Hypertension - Hyperlipidaemia - Family history
What is examined during CVS examination?
Hands, face, chest, legs
What are you examining the hands for?
Nicotine staining Finger clubbing Signs of endocarditis (endocarditis can lead to chest pain)
What is endocarditis?
Infection of the inner lining of the heart (the endocardium).
What are you examining the hands for?
Malar flush (sign of mitral stenosis) Corneal arcus Xanthelasma
What is corneal arcus and xanthelasma signs of?
Hypercholesterolemia
What are you examining the chest/body for?
Scars (previous operations) Chest wall abnormalities