Cardio history taking Flashcards
What does Socrates stand for?
Site Onset Character Radiation Associated symptoms Timing Exacerbating /relieving Severity
Associated symptoms in chest pain
Sob- orthopnoea, paroxysmal nocturnal dyspnoea, pillows, exercise, Autonomic - nausea, vomiting, sweating Palpitations Syncope Ankle/calf swelling Haemoptysis Sputum Trauma
Exacerbating/relieving features of chest pain
Exercise Food Position Gym Analgesia Pleuritic
Pmh in chest pain
mi Diabetes Hypercholesterolaemia PVD Stroke Rheumatic fever
Medication history in chest pain
Allergy
Ace and beta blockers
Social history in chest pain
Smoking Passive smoking Diet Exercise Housing and stairs Alcohol Substances
Modifiable risk factors for heart disease
Smoking and alcohol Hypercholesterolaemia Obesity Hypertension Diabetes Sedentary lifestyle Poor medication compliance Stress
Non modifiable risk factors for heart disease
Age
Male
Family history
Previous cvd
History of unstable angina
Angina occurring with increasing frequency, unpredictably or at rest
ECG in unstable angina
Normal or show St depression or t wave changes
ECG in nstemi
St depression or t wave changes
ECG changes in stemi
As for nstemi plus St elevation >2mm I’m 2 contiguous chest leads
History of pericarditis
Pleuritic chest pain worse lying supine
Saddle shaped St elevation
Pr depression
Hear perdicsrdial rub on auscultaton
History of aortic dissection
Sudden onset
Tearing excruciating pain radiating to the back
More common in those with hypertension
Respirstory causes of chest pain
PE
pneumonia
Pneumothorax
Pe history
Sob Pleuritic chest pain Haemoptysis Dizziness Syncope
Pneumonia history
Sob
Temperature
Purulent cough
Pleuritic chest pain
Pneumothorax history
Sudden onset Sob Pleuritic chest pain Cigarette smokers Asthma Copd Marfans
Gi causes of chest pain
Gord Peptic ulcer disease Stress ulcer Hiatus hernia Oesophageal spasm
Immediate treatment of Acs
Romance Reassure Oxygen Moprhine Aspirin 300mg Nitroglycerine Clopidogrel 300mg Enoxaparin
Investigation of acs
Bloods - tnx, u&e’s, tfts, glucose, cardiac enzymes, lipid profile
Chest x-ray- widened mediastinum may increase suspicion of aortic dissection, lv failure
Serial ecgs
Presentation of chest pain
Age Sex Pain history Associated symptoms Omg Likely diagnoses Management
