CARDIO Common Cardiovascular Complaints Flashcards
most common complaint among patients with cardiac conditions
chest pain
other noncardiac causes of pain are
vascular pulmonary gastrointestinal dermatomal psychiatric
chest pain that are acute or potentially life threatening condition that needs urgent management
acute coronary syndrome (Unstable angina, NSTEMI,STEMI)
Aortic dissection
Pulmonary embolism
Spontaneous pneumothorax
duration of chest pain in ACS
> 10-30 mins
duration of chest pain
aortic dissection
sudden onset of unrelenting pain
duration of chest pain
spontaneous pneumothorax
sudden onset
several hours
quality of chest pain in ACS
pressure
tightness
squeezing
heaviness
quality of chest pain in aortic dissection
sharp, tearing, knife-like or ripping pain
pulmonary embolism
quality of chest pain
pleuritic pain - small emboli
larger ones- dyspnea
quality of chest pain in spontaneous pneumothorax
pleuritic
location of chest pain in ACS
retrosternal
radiation to neck, jaw, shoulders or arms (left)
location of chest pain in aortic dissection
anterior chest, often radiating to the back,
between the shoulder blades
compare the chest pain of ACS vs stable angina
same chest pain but occurs with low levels of exertion or at rest
less relief with nitrates
differentiate UA from NSTEMI and STEMI
elevated cardiac biomarkers
ST-segment elevation on ECG in STEMI vs UA and NSTEMI
what conditions are associated with aortic dissection
hypertension
underlying tissue disorder e.g. Marfan syndrome
pulmonary embolism
general PE
with dyspnea
tachypnea
tachycardia
if pulmonary embolism is due to a large embolus, hypotension is due to ____ dysfunction
right ventricle
signs and symptoms of spontaneous pneumothorax
dyspnea
chest lag
decreased breath sounds ipsilaterally
chest pain due to chronic condition that could lead to a serious complication
chronic stable angina
aortic stenosis
plumonary hypertensin
CSAP
chronic stable angina pectoris
character of chest pain
2-10 minutes
pressure, lightness, squeezing, heaviness
retrosternal
radiation to neck, jaw shoulders or arms (left)
chaacter of chest pain for aortic stenosis
variable duration
pressure, lightness, squeezing, heaviness
retrosternal
radiation to neck, jaw shoulders or arms (left)
character of chest pain in pulmonary hypertension
variable duration
quality: pressure
substernal
what precipitates chest pain in chronic stable angina pectrosis (CSAP)
exercise
cold weather
psychological stress
in this condition there is a late-peaking systolic murmur radiating to carotids
aortic stenosis
what condition is associated with the following findings
chest pain usually with exertional dyspnea
signs of increased venous pressure (RVH)
and loud P2
pulmonary hypertension
what are the etiology that would manifest as chest pain that may warrant specific (LESS URGENT) treatment
acute pericarditis
pneumonia
Herpes zoster
etiologies that would present as chest pain due to other chronic treatable conditions
esophageal reflux peptic ulver biliary colic costochondritis tietze syndrome emotional/ psychiatric
all differentials for chest pain
Acute coronary syndrome ACS (Unstable Angina, NSTEMI, STEMI) Aortic dissection Pulmonary embolism Spontaneous pneumothorax Chronic Stable Angina Aortic Stenosis Pulmonary Hypertension
Acute Pericarditis
Pneumonia
Herpes Zoster
Esophageal reflux Peptic ulcer Biliary colic Costochondritis Tietze syndrome Emotional/Psychiatric
Chest pain in acute pericarditis is characterized as
duration of hours to days
sharp
retrosternal or toward the apex
may radiate to left shoulder or trapezius ridge
relieved by sitting up and leaning forwar
exercerbated by deep inspiration and lying flat
pericardial friction rub may be present
chest pain in pneumonia is characterized by
duration lasting days
pleuritic
unilateral
common signs and symptoms of pneumonia
dyspnea
productive cough
fever
rales
chest pain in herpes zoster
is characterized as
variable in duration
burning pain
dermatomal distribution
accompanied by vesicular rash
chest pain in esophageal reflux is characterize das
lasting 10-60 mins burning pain epigastric radiating to substernal area worsened by recumbency after meals relieved by antacids and nitrates
chest pain in peptic ulcer is characterized as
prolonged pain
burning
epigastric radiating to substernal area or scapula
may be relieved by food intake or antacids
Biliary colic pain is characterized as
prolonged
steady, aching or colicky
RUQ / epigastric radiating to substernal area or scapula
usually after a heavy meal
costochondritis
pain is characterized as
variable duration intense fleeting pain sternal/ chest wall may be reproduced by localized or pinpoint pressure on exam Without swelling of costochondral joints
Tietze syndrome
pain is characteried as
variable pain
intense fleeting pain
sternal/ chest wall
may be reproduced by localized or pinpoint pressure on exam
with tender swelling of costocondral joints
emotional/ psychiatric chest pain is characterized as
varible
fleeting
variable location
situational factors precipitate symptoms
other common cardiac complaints after chest pain
dyspnea
palpitations
syncope
cardiac causes of dyspnea usually occur with ____
exertion
dyspnea on recumbency or lying flat
orthopnea
dyspnea while standing
platypnea
in the making of a cardiac diagnosis what are the underlying etiologies to be considered
is it congenital, hypertensive, ischemic or inflammatory?
what are the steps in making a cardiac diagnosis
- underlying etiology
- anatomic abnormalities
- physiologic disturbances
- Functional disability
what are the anatomic abnormalities to be considered in cardiac diagnosis
which chambers are involved? are they hypertrophied, dilated, or both
which valves are affected? are they regurgitant and/stenotic?
is there pericardial involvement? has there been myocardial infarction?
what are physiologic disturbances to be considered in cardiac diagnosis
is arrhythmia present?
is there evidence of congestive heart failure or myocardial ischemia ?
what are the things to be considered in functional disability in cardiac diagnosis
how strenuous is the physical activity required to elicit symptoms?
NYHA stands for
New York Heart Association Functional Classification
