Cardio history taking

Question 1

What are the 5 main cardiovascular symptoms?

Answer 1

1. Chest pain
2. Breathlessness
3. Palpitations
4. Lightheadedness
5. Swelling

Question 2

What are the common and serious causes of chest pain?

Answer 2

Common:

• Acid reflux
• Angina
• Infection
• Costochondrosis

Serious:

• Pericarditis
• MI
• PE
• tension pneumothorax
• aortic dissection

Question 3

Why do palpitations occur in simple terms?

Answer 3

Due to tachycardia and increased myocardial contractility

This is because of increased sympathetic tone to the heart due to a decreased CO or anxiety.

Question 4

What are the different types of “dizziness”?

Answer 4

Syncope - blackout/lightheadedness

Vertigo - room is spinning

Unsteadiness - cerebellar, imbalance

Question 5

What kind of chest pain will you get if there is a problem with the heart and why?

Answer 5

DULL because the myocardium is not well innervated so the pain will be hard to localise.

Question 6

What questions would you ask in a cardiac systems review?

Answer 6

• How many pillows do you sleep on?
• Worse after meals (if pain)?
• Has anyone in your family had a heart attack at a young age?/Has anyone died of any heart problems?
• Do you have… high BP/cholesterol/reflux/diabetes?

Question 7

Which two heart conditions can cause sudden death?

Answer 7

HOCM - hypertrophic obstructive cardiomyopathy - problems with the myocyte alignment can cause mismatch in conractility and sudden death

ARVD - Arrhythmogenic Right Ventricular Dysplasia thin wall of the ventricle also causes alignment problems which leads to sudden death