Cardio week: Hx & Ex Flashcards
Cardiac causes of dyspnoea
- heart failure
- angina
- PE
- pulmonary hypertension
- anaemia
Which group of people may experience silent heart attacks (no symptoms)
Diabetics
Cardiac causes of syncope
- arrhythmias
- postural hypotension
- hypertrophic cardiomyopathy
- aortic stenosis
- atrial myxoma
Causes of unilateral leg oedema
- DVT
- soft tissue infection
- trauma
- immobility
- lymphoedema
Causes of bilateral leg oedema
- Heart failure
- chronic venous insufficiency
- hypoproteinaemia
- lymphatic obstruction
- drugs
- thiamine deficiency
- immobility
Drugs that cause dyspnoea
- beta blockers (for asthma, heart failure)
- CCB
- NSAIDs
Drugs that cause oedema
- steroids
- NSAIDs
- CCB eg amlodipine
Drugs that cause angina
- thyroxine
- drug induced anaemia (aspirin or NSAIDs)
What heart conditions are related to COPD
- Atrial fibrillation
- Cor pulmonale
What heart conditions are related to cancer or cytotoxic drugs
Heart failure
What heart conditions are related to rheumatoid disease
- Pericarditis
- Raynaud’s (associated with RA)
Cardiac causes of clubbing
BACTERIAL ENDOCARDITIS
ANY DISEASE FEATURING CHRONIC HYPOXIA
- congenital cyanotic heart disease
- atrial myxoma
- tetralogy of fallot
- other causes of R to L shunting
What are the 4 features of tetralogy of fallot
- Ventricular septal defect
- Pulmonary stenosis
- RV hypertrophy
- Overriding aorta
Signs of endocarditis on hands
Splinter haemorrhages, Janeway lesions, Osler’s nodes
What does a bounding pulse indicate
CO2 retention
What does a collapsing pulse/ water hammer pulse indicate
Aortic regurgitation
What does radio-radial delay indicate
Coarctation of aorta
What does unequal strength of pulse indicate
Aortic dissection
What does slow rising pulse indicate
Aortic stenosis
What kind of murmur does a malar flush indicate
Mitral stenosis
due to CO2 retention and its vasodilatory effects
Where do you auscultate for:
- mitral regurgitation
- mitral stenosis
- aortic regurgitation
- aortic stenosis
-mitral regurgitation:
Diaphragm in axilla on expiration (roll left)
-mitral stenosis:
Bell at mitral valve
-aortic regurgitation:
Diaphragm on L LSE in expiration
-aortic stenosis:
Bell over carotids
Cardinal symptoms in CVS examination
- chest pain
- shortness of breath
- palpitations
- dizziness
- swelling
- claudication
- weight loss
- fever
What is unstable angina otherwise known as
Acute coronary syndrome
(this is an emergency).
Angina type symptoms but at rest
In terms of blood pressure and heart size, what would you find with aortic stenosis
Narrow pulse pressure
LV hypertrophy
Triad of cardinal symptoms in aortic stenosis
Chest pain (angina)
Syncope
Dyspnoea
Aortic stenosis and Aortic regurgitation
Which cause widened/narrowed pulse pressure?
Aortic stenosis: narrowed pulse pressure
Aortic regurgitation: widened pulse pressure
Important PMH to get in a cardiac history
+ what cardiac conditions the other conditions are related to
- hypertension
- high cholesterol
- diabetes
- kidney disease
- hyperthyroidism (a fib)
- chronic lung disease (a fib, cor pulmonale)
- rheumatoid arthritis (raynaud’s phenomenon)
- childhood: rheumatic fever (endocarditis), heart murmur
What is coarctation of aorta
Congenital narrowing of aorta
S1 + S2
-which coincides with the peripheral pulse
S1
S1 + S2
-which coincides with the closure of which valves
S1: closure of M and T
S2: closure of A and P
