Cardiac Pain Flashcards

1
Q

SOCRATES for cardiac chest pain?

A

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

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2
Q

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?

A

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

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3
Q

What is the difference between stable angina and non-stable angina?

A

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.

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4
Q

What are the common presenting symptoms in CVS disease?

A

Dyspnoea Oedema Palpitations Syncope / pre-syncope

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5
Q

What can respiratory problems can cause chest pain?

A

Cough, temperature, haemoptysis, risk factors for PE

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6
Q

What GI problems can cause chest pain?

A

Pain related to eating, reflux, burning, indigestion, swallowing difficulty, vomiting or regurgitation

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7
Q

What musculo-skeletal problems can cause chest pain?

A

Recent falls, injury, trauma

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8
Q

What psychological problems can cause chest pain?

A

Anxiety, stress, recent life events

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9
Q

What are the common CVS risk factors to ask about?

A
  • Diabetes - Smoking - Diet and exercise - Hypertension - Hyperlipidaemia - Family history
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10
Q

What is examined during CVS examination?

A

Hands, face, chest, legs

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11
Q

What are you examining the hands for?

A

Nicotine staining Finger clubbing Signs of endocarditis (endocarditis can lead to chest pain)

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12
Q

What is endocarditis?

A

Infection of the inner lining of the heart (the endocardium).

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13
Q

What are you examining the hands for?

A

Malar flush (sign of mitral stenosis) Corneal arcus Xanthelasma

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14
Q

What is corneal arcus and xanthelasma signs of?

A

Hypercholesterolemia

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15
Q

What are you examining the chest/body for?

A

Scars (previous operations) Chest wall abnormalities

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16
Q

What are you examining the legs for?

A

Oedema (pitting) Scars

17
Q

During auscultation, what is the first heart sound produced by?

A

Closing of the mitral and tricuspid valve leaflets

18
Q

What is the second heart sound produced by?

A

Closing of the aortic and pulmonic valve leaflets

19
Q

Auscultation space for aortic valve?

A

2nd/3rd right intercostal space (right sternal border)

20
Q

Auscultation space for pulmonic valve?

A

2nd-3rd left interspace (just left of sternum)

21
Q

Ausculatation space for tricuspid valve?

A

Left sternal border (around 4th left intercostal space)

22
Q

Auscultation for mitra valve?

A

Apex of heart –> left mid clavicular line 5th intercostal space

23
Q

Howd.o heart sounds time in with carotid pulse?

A
  • Feel carotid pulse while you listen
  • Hear first heart sound when you feel pulse hit your fingers
  • As pulse pulls away, this is when you hear second heart sound
24
Q

What are heart mumurs?

A

The absence of silence between heart sounds; can be systolic or diastolic

25
Q

Is diastole or systole longer?

A

Diastole - hence the ‘lub-DUP’

26
Q

What is purpose of a Haemoglobin A1c test?

A

A blood test that reflects your average blood glucose levels over the past 3 months - increasing levels of HbA1c in non-diabetic patients with stable angina pectoris are associated with the severe atherosclerosis that may help to predict the increased risk for coronary artery disease.

27
Q
A