Cardiac Signs And Symptoms Flashcards
What are cardinal symptoms?
Primary/Major symptoms to make a diagnosis.
What are examples of cardinal symptoms?
Chest pain, breathlessness, palpitations, syncope, haemoptysis and oedema.
What are the cardinal symptoms for cardiovascular disease?
Chest pain, breathlessness, syncope and increased micrutition at night.
What questions do we elicit when doing a history for chest pain?
Intensity, Duration and Localisation of pain
Referred pain
Change in posture
Influenced by food or fluid intake
Reaction to nitroglycerin
Why is it important to determine if patient has a reaction to nitric glycerin?
Nitrin glycerin is an ingredient in GTN spray, a vasodilator drug to treat angina.
What are non-ischaemic causes of angina?
Myocarditis and Pericarditis
Cardiomyopathy
This presents as crushing, central chest pain.
What are the ischaemic causes of angina?
Acute myocardial infarction
Acute coronary syndrome
What is angina?
Ischaemia which blocks blood supply to the cardiac supply that causes chest discomfort and radiates to the chest and jaw. It is relieved by rest and brought on by exertion or emotional stress. It is worsened in the cold and lasts for 2-10 minutes.
What is the presentation of myocardial infarction?
It occurs at rest and builds up over a few minutes and can last for over 30 minutes. There is no relief with GTN spray and patient is breathless, sweatiness, nausea and fear.
What is pericarditis?
Inflammation of the pericardium, a double layered fibroelastic sac which results in pleural effusion in the pericardial space between the visceral and parietal layer that can lead to heart failure.
What is aortic dissection?
Damage to the tunica intima of the aorta which results in the pooling of blood between the tunica intima and tunica media that typically occurs due to chronic hypertension. There is sharp chest pain which radiates to the back and this commonly occurs in the abdomen. An aneurysm may form which can burst and cause severe pain and loss of consciousness.
What are the causes of cardiac breathlessness?
Pulmonary oedema
Chronic heart failure
Paroxysmal nocturnal dyspnoea
How does pulmonary oedema present?
Pulmonary oedema is fluid build up in the alveoli which typically occurs due to congestive heart failure.
Symptoms are abrupt with orthopnoea, pink frothy sputum and cold and claminess occurring.
What is paroxysmal nocturnal dyspnoea?
Occurs after 1-2 hours of sleep where there is shortness of breath which causes coughing and wheezing that can last for 30 minutes and is typically relieved when being in an upright position.
What is chronic heart failure?
Typically occurs due to coronary artery disease. It presents with exertional breathlessness which is relieved with rest, ankle oedema and nocturnal cough.
What is the NHYA classification?
Classification of heart failure from no symptoms to symptoms presenting at rest.
What is syncope?
Brief loss of consciousness typically due to cerebral hypotension. There is rapid onset with spontaneous recovery
What is stable angina?
Relieved by GTN spray and rest/
What is unstable angina?
Not relieved by rest and is a type of acute coronary syndrome.
How does cardiac syncope present?
Occurs due to cardiac pathology which has a sudden onset, and full recovery. There is no jerks and no incontinence.
How does neurological syncope present?
Vasovagal syncope which overreacts to intense emotion, dehydration or standing for long periods of time. There is prodrome (pre-symptoms) with incontinence, convulsion and post-ictal symptoms.
How does vasodepressor syncope?
Sudden fall in peripheral resistance with little change in cardiac output. It occurs after prolonged standing or social anxiety which develops faintness and greying out of vision.
