Cardiovascular

Question 0

Report vitals if:

Answer 0

BP is above 160 
Temp is above 100 
HR above 100 
RR above 20 
Pulse Ox below 94

Question 1

HPI : all 8 sections

And additional questions:

Answer 1

1) What were you doing when the pain started? (Exertional vs. nonexertional pain)
2) Do you have a hx of prior episodes or prior hx of cardiac disease?
3) Did you take any blood thinners (ie. ASA) or NTG ? Did it help? (Anticoagulant)
4) Do you have any associated SOB, N/V, diaphoresis, or numbness/tingling?

Question 2

Some common abnormal findings for CP:

Answer 2

1) General: (mild/moderate/severe) distress, diaphoretic
2) CV: (tachycardia, bradycardia, irregularly regular rhythm), (left/right) anterior chest wall tenderness (to palpation), (1/2/3/4+) pitting edema
3) Respiratory: Tachypneic

Question 3

EKG:

Answer 3

Remember you need 3 findings!

You always need to record the time the EKG was done and the rate (i.e 86 bpm)

Some common EKG findings:

1) NSR at 86 bpm, sinus tachycardia at 128 bpm, sinus bradycardia at 30 bpm, atrial fibrillation
2) no acute ST or T changes
3) no STEMI
4) Normal PQRS intervals
5) normal axis

Question 4

DDX:

Answer 4

• ACS (acute coronary syndrome)
• PE (pulmonary embolism)
• Atypical CP
• MI
• aortic dissection
• chest wall pain/musculoskeletal pain
• CAD

Question 5

MDM: common treatments given to patient’s with chest pains to help you become familiar with the term and spelling:

Answer 5

IV fluids (hydrates pt)
ASA and/or NTG (medication)
Troponin (lab test ordered to measure cardiac enzymes)