Cardiovascular History

Question 1

Cardiovascular Primary Survey

Answer 1

• GCS 15
• consider ABCDE
• no obvious distress eg clammy, pain
• no Levine sign
• good colour

Question 2

Focused History Questions

Answer 2

• Chest Pain
• Palpitations
• Dyspnoea/SOB
• Fatigue/Dizziness/Syncope
• Oedema
• Leg Cramps/PE

Question 3

Palpitations Questions

Answer 3

• have you ever experienced palpitations?
• how long has this been going on for?
• is this normal for you?
• it’s a sign of cardiac arrhythmias especially in young people
• can be caused by stress, anxiety, caffeine, nicotine. Also a medication side effect

Question 4

Fatigue/Dizziness/Syncope

Answer 4

• do you feel more fatigued than normal?
• any LOC?
• any dizziness?

Question 5

Leg Cramps

Answer 5

• any pain in the calves? DVT
• caused by artery disease
• immobility?
• contraceptive pill?
• long haul flights?
• recent surgeries?

Question 6

Dyspnea and SOB Questioning

Answer 6

• have you felt SOB at all recently?
• what were you doing when it started?
• is it worse in excretion?
• does anything help the SOB?
• are younjormally SOB? Is it worse than normal?
• do you get SOB at night? = paroxysmal nocturnal dysonoea
• possible causes = MI, AF, PE, LVF, angina

Question 7

Oedema Questioning

Answer 7

• peripheral oedema suggest heart failure
• does the pt take diuretics?
• is it pitting oedema
• several oedema? If sit down alot
  LVF can cause severe pulmonary oedema
• can be caused by heart failure, DVT and renal failure

Question 8

Chest Pain Questioning

Answer 8

• do you have any chest pain?
• does the pain ease when moving forwards? = pericarditis
• have you hadnindigestion?
• any arm or jaw numbness?
• angina? Has it been normal for then?
• Stable angina = pain on movement
• Unstable angina = constant pain not managed by pain relief

Question 9

SOCRATES

Answer 9

S where is the pain?
O gradually, suddenly?
C describe the pain, dull, sharp, weight
R does the pain radiate anywhere
A Assoc symptoms, dizzy, SOB, nauesea
T when did it start?
E does anything make it better/worse
S score the pain from 1-10

Question 10

Cardiovascular PMH

Answer 10

• Previous mix?
• do you have any known cardiac problems?
• any FH is cardiac problems?
• do you have a pacemaker or stent?
• do you take recreational drugs?
• are you a smoker?
• what do you do for work?
• HF, angina, arrhythmias, AF, hypertension