CARDIO Common Cardiovascular Complaints

Question 1

most common complaint among patients with cardiac conditions

Answer 1

chest pain

Question 2

other noncardiac causes of pain are

Answer 2

vascular
pulmonary
gastrointestinal
dermatomal
psychiatric

Question 3

chest pain that are acute or potentially life threatening condition that needs urgent management

Answer 3

acute coronary syndrome (Unstable angina, NSTEMI,STEMI)
Aortic dissection
Pulmonary embolism
Spontaneous pneumothorax

Question 4

duration of chest pain in ACS

Answer 4

> 10-30 mins

Question 5

duration of chest pain

aortic dissection

Answer 5

sudden onset of unrelenting pain

Question 6

duration of chest pain

spontaneous pneumothorax

Answer 6

sudden onset

several hours

Question 7

quality of chest pain in ACS

Answer 7

pressure
tightness
squeezing
heaviness

Question 8

quality of chest pain in aortic dissection

Answer 8

sharp, tearing, knife-like or ripping pain

Question 9

pulmonary embolism

quality of chest pain

Answer 9

pleuritic pain - small emboli

larger ones- dyspnea

Question 10

quality of chest pain in spontaneous pneumothorax

Answer 10

pleuritic

Question 11

location of chest pain in ACS

Answer 11

retrosternal

radiation to neck, jaw, shoulders or arms (left)

Question 12

location of chest pain in aortic dissection

Answer 12

anterior chest, often radiating to the back,

between the shoulder blades

Question 13

compare the chest pain of ACS vs stable angina

Answer 13

same chest pain but occurs with low levels of exertion or at rest
less relief with nitrates

Question 14

differentiate UA from NSTEMI and STEMI

Answer 14

elevated cardiac biomarkers

ST-segment elevation on ECG in STEMI vs UA and NSTEMI

Question 15

what conditions are associated with aortic dissection

Answer 15

hypertension

underlying tissue disorder e.g. Marfan syndrome

Question 16

pulmonary embolism

general PE

Answer 16

with dyspnea
tachypnea
tachycardia

Question 17

if pulmonary embolism is due to a large embolus, hypotension is due to ____ dysfunction

Answer 17

right ventricle

Question 18

signs and symptoms of spontaneous pneumothorax

Answer 18

dyspnea
chest lag
decreased breath sounds ipsilaterally

Question 19

chest pain due to chronic condition that could lead to a serious complication

Answer 19

chronic stable angina
aortic stenosis
plumonary hypertensin

Question 20

CSAP
chronic stable angina pectoris
character of chest pain

Answer 20

2-10 minutes
pressure, lightness, squeezing, heaviness
retrosternal
radiation to neck, jaw shoulders or arms (left)

Question 21

chaacter of chest pain for aortic stenosis

Answer 21

variable duration

pressure, lightness, squeezing, heaviness
retrosternal
radiation to neck, jaw shoulders or arms (left)

Question 22

character of chest pain in pulmonary hypertension

Answer 22

variable duration
quality: pressure
substernal

Question 23

what precipitates chest pain in chronic stable angina pectrosis (CSAP)

Answer 23

exercise
cold weather
psychological stress

Question 24

in this condition there is a late-peaking systolic murmur radiating to carotids

Answer 24

aortic stenosis

Question 25

what condition is associated with the following findings chest pain usually with exertional dyspnea signs of increased venous pressure (RVH) and loud P2

Answer 25

pulmonary hypertension

Question 26

what are the etiology that would manifest as chest pain that may warrant specific (LESS URGENT) treatment

Answer 26

acute pericarditis pneumonia Herpes zoster

Question 27

etiologies that would present as chest pain due to other chronic treatable conditions

Answer 27

``` esophageal reflux peptic ulver biliary colic costochondritis tietze syndrome emotional/ psychiatric ```

Question 28

all differentials for chest pain

Answer 28

``` 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 ```

Question 29

Chest pain in acute pericarditis is characterized as

Answer 29

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

Question 30

chest pain in pneumonia is characterized by

Answer 30

duration lasting days pleuritic unilateral

Question 31

common signs and symptoms of pneumonia

Answer 31

dyspnea productive cough fever rales

Question 32

chest pain in herpes zoster | is characterized as

Answer 32

variable in duration burning pain dermatomal distribution accompanied by vesicular rash

Question 33

chest pain in esophageal reflux is characterize das

Answer 33

``` lasting 10-60 mins burning pain epigastric radiating to substernal area worsened by recumbency after meals relieved by antacids and nitrates ```

Question 34

chest pain in peptic ulcer is characterized as

Answer 34

prolonged pain burning epigastric radiating to substernal area or scapula may be relieved by food intake or antacids

Question 35

Biliary colic pain is characterized as

Answer 35

prolonged steady, aching or colicky RUQ / epigastric radiating to substernal area or scapula usually after a heavy meal

Question 36

costochondritis | pain is characterized as

Answer 36

``` variable duration intense fleeting pain sternal/ chest wall may be reproduced by localized or pinpoint pressure on exam Without swelling of costochondral joints ```

Question 37

Tietze syndrome | pain is characteried as

Answer 37

variable pain intense fleeting pain sternal/ chest wall may be reproduced by localized or pinpoint pressure on exam with tender swelling of costocondral joints

Question 38

emotional/ psychiatric chest pain is characterized as

Answer 38

varible fleeting variable location situational factors precipitate symptoms

Question 39

other common cardiac complaints after chest pain

Answer 39

dyspnea palpitations syncope

Question 40

cardiac causes of dyspnea usually occur with ____

Answer 40

exertion

Question 41

dyspnea on recumbency or lying flat

Answer 41

orthopnea

Question 42

dyspnea while standing

Answer 42

platypnea

Question 43

in the making of a cardiac diagnosis what are the underlying etiologies to be considered

Answer 43

is it congenital, hypertensive, ischemic or inflammatory?

Question 44

what are the steps in making a cardiac diagnosis

Answer 44

1. underlying etiology 2. anatomic abnormalities 3. physiologic disturbances 4. Functional disability

Question 45

what are the anatomic abnormalities to be considered in cardiac diagnosis

Answer 45

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?

Question 46

what are physiologic disturbances to be considered in cardiac diagnosis

Answer 46

is arrhythmia present? | is there evidence of congestive heart failure or myocardial ischemia ?

Question 47

what are the things to be considered in functional disability in cardiac diagnosis

Answer 47

how strenuous is the physical activity required to elicit symptoms?

Question 48

NYHA stands for

Answer 48

New York Heart Association Functional Classification