Cardiac Symptoms and Signs Flashcards
State four cardinal symptoms of cardiovascular disease
- Chest Pain
- Breathlessness
- Palpitations
- Syncope
What are the three characteristics of typical / definite angina?
- Substernal chest discomfort
- Provoked by exertion
- Relieved by rest or GTN
What does SOCRATES stand for?
Site Onset Character Radiation Alleviating factors Time Exacerbating factors Severity
Where might angina radiate to?
Left / right arm, jaw
What is Pericarditis?
Inflammation of pericardium
What does GTN stand for? What is its mechanism of action
Glyceryl tri-nitrate.
A prodrug, which is reduced to NO, and promotes vasodilation. Used to treat angina
What is an adverse effect of vasodilation caused by GTN?
Patient becomes hypotensive
What is the most common cause of Pericarditis?
Viral infection
On an ECG, what would you expect to see which may suggest Pericarditis?
Concave ST elevation and PR depression
Outline the characteristics of pain in an Aortic dissection
Sudden, tearing pain which radiates to the back. Abdominal pain as well.
Outline the characteristics of pain in a Pulmonary Embolus
Plueretic pain (worse on inspiration), associated with Shortness of Breath
What test can be performed to confirm a diagnosis of a Pulmonary Embolism or Aortic Dissection?
D-Dimer test
What is the normal respiratory rate per minute?
16 - 20 breaths per minute
What is the term for faster breathing than normal?
Tachypnoea
What is Orthopnoea?
Shortness of breath when lying flat
What is Paroxysmal Noctural Dyspnoea?
Waking up from sleep at night
What does pink frothy sputum suggest?
Pulmonary Oedema
What is the underlying mechanism of Syncope?
Transient global cerebral hypoperfusion
What is Syncope defined as?
Transient loss of consciousness and postural tone with rapid recovery
Central cyanosis is defined as having Oxygen saturation less than 80%, or how many g of deoxyhaemoglobin per decilitre?
5g or more
In clubbing, what angle is the fingernail bed at?
Greater than 180 degrees
What is the significance of the first heart sound?
Closure of the AV valves: Mitral and Tricuspid
What is the significance of the second heart sound?
Closure of the Aortic and Pulmonary valves
A normal JVP is less than what height?
Less than 3cm
What is a “Thrill”?
A palpable murmur
When does the 3rd heart sound occur?
Beginning of diastole, after S2
When does the 4th heart sound occur?
End of diastole, before S1
In an Aortic valve prosthesis - what kind of murmur can you hear?
Systolic ejection murmur
In a Mitral valve prosthesis - what kind of murmur can you hear?
Diastolic flow murmur
Where are Osler’s nodes found?
Usually fingertips, toe-tips, thenar and hypothenar eminences
Where are Janeway lesions found?
Soles, palms, thenar and hypothenar eminences, plantar aspect of foot
Which are painful: Osler’s nodes or Janeway lesions?
Osler’s nodes are painful
Janeway lesions are not
