Cardio

Question 1

Hx OF PC

What symptoms should be discussed in the Hx of PC?

Answer 1

• Chest pain.
• Dyspnoea.
• Palpitations.
• Syncope.
• Exercise tolerance.

Question 2

Hx OF PC

What would you ask about in chest pain?

Answer 2

• SOCRATES.

- Associated symptoms include sweating, nausea, SOB, palpitations.

Question 3

Hx OF PC

What features of a Hx would make cardiac ischaemia unlikely?

Answer 3

• Knife-like, sharp, stabbing, pleuritic chest pain.
• Lest sub-mammary, left hemi-thorax.
• Exacerbating factors like pain after exercise/specific body motion.

Question 4

Hx OF PC

What would you ask about in dyspnoea?

Answer 4

• Cough, sputum, blood?
• Swollen ankles? Weight gain?
• Ever woken up in the night SOB? (PND).
• How long it’s been like this.
• Effect on ADLs.
• # pillows used at night.

Question 5

Hx OF PC

What would you ask about in palpitations?

Answer 5

• Have you had any/felt your heart racing?
• Does anything seem to provoke this?
• Start suddenly or build gradually?
• Stop suddenly or stop gradually?
• How long it lasts?
• Any other symptoms?
• Can you tap the rhythm?

Question 6

Hx OF PC

What would you ask about in syncope?

Answer 6

• Before: what were you doing? Do you remember it? How did you feel?
• During: was it witnessed?
• After: how did you feel? Any incontinence/confusion? Recovery time.

Question 7

Hx OF PC

What would you ask about in exercise tolerance?

Answer 7

• How far you can walk on flat until you stop now/in past.
• How long has this deteriorated over (short or long time)?
• What limits how far you can walk (SOB/chest pain).
• Any CP when you walk?
• SOB up hills/stairs?

Question 8

PMH/FH

What would you specifically ask about in PMH/FH?

Answer 8

• Similar episodes.
• Any problems with heart/thrombotic events.
• Previous cardiac surgery.
• Family Hx of IHD/CVA <60y/o is significant.

Question 9

PMH/FH

What risk factors would you ask about in PMH?

Answer 9

Have the doctors ever said you have…

• Diabetes?
• HTN?
• High cholesterol?
• VTE risk factors.

Question 10

DH

What drugs would you ask about in DH?

Answer 10

• Anti-HTN, any cardiac drugs.
• Drugs with cardiac side effects like corticosteroids (HTN, fluid retention), or drugs causing sinus tachy (salbutamol, thyroxine).
• OTC drugs like aspirin.
• ALLERGIES!

Question 11

SH

What would you ask about in SH?

Answer 11

• Smoking (risk factor).
• Alcohol.
• Occupation.
• Diet/stress.
• ?Cocaine use.