cardio hx

Question 1

what are the questions you need to ask in a general cardiac hx?

Answer 1

1) hx of chest pain - socrates
2) hx of palpitation
3) SOB, dyspnoea, paroxysmal nocturnal dyspnoea
4) hx of ankle oedema
5) hx of syncope
6) hx of intermittent claudication
7) hx of fatigue

Question 2

PMH required in cardiac hx

Answer 2

1) PMH of MI, stroke, palpitation, rheumatic fever, DM, asthma, hypercholesterolemia, HTN

Question 3

why do you need to ask about asthma in cardiac hx?

Answer 3

to avoid giving beta-blocker which will worsen the asthma

Question 4

FHx included in cardiac hx?

Answer 4

stroke/MI before age of 65

Question 5

what should be included in chest pain hx?

Answer 5

SOCRATES

any previous similar episode?
noticed any ankle/leg swelling?

specific RF about MI - prev MI, DM, HTN, hypercholesteraemia, FHx, smoking

any previous hx of PE/DVT, immobility, malignancy, pregnancy, long haul travel, recent surgery

Question 6

what should be included in palpitations hx?

Answer 6

1) what does pat mean by palpitations
2) can they tap it out?
3) anything that starts the arrhythmia
4) anything which stops the arrhythmia
5) is the arrhythmia sudden onset or insidious?
6) any associated symptoms eg syncope, SOB, chest pain
7) any episode of cardiac hx / HTN
8) noticed any weight loss, heat intolerance, inc stool frequency or irritability recently?
9) noticed being more stress
10) smoking/alcohol use
11) illicit drugs use - esp cocaine
12) any current meds

Question 7

what are the questions which should be asked in intermittent claudication hx?

Answer 7

1) what pt mean by intermittent claudication
2) where is the pain the leg?
3) how far does the pat have to walk before pain onset
4) how long does the pt needs to rest before pain relief?
5) is the distance before pain onset reducing/staying the same?
6) pain even when at rest esp when the leg has hang out of bed?
7) does bending forward relieve pt’s pain
8) does pt have any neuro symptoms eg back pain/weakness, tingling or numbness
9) if importance?
10) noticed any skin changes - eg dry skin and hairless
11) any PMH - DM, HTN, hypercholesteraemia, smoking, FHx
12) any thx of angina, mi or strokes