cardiovascular hx Flashcards
presenting - chest pain
just do a normal hx based around socrates for Pc. HPc, PMSH, FH, SH, DH, risk factors based on your mental DD. leg swelling.
radiation of pain from disease of the cervcal or upper thoracic vertebrae.
usually radiates from the back to the front of the chest.
pain from a dissecting aortic aneurysm radiates to
to the back
pain of a massive PE
either angina like or a pleuritic pain and thus can be confusing
pain of oesophageal spasm?
similar to GORD. associated with heartburn and dysphagia.
nitrates tend to relieve angina pain but why is this not specific?
they can also relieve the pain of oesophageal spasm. it is different however in that it can be precipitated by hot or cold drink consumption
what does unilateral chest pain suggest
that there may be a DVT and thus a PE is likely.
the character of pleuritic chest pain
made worse by inspiration and usually alleviated by siting up and leaning forward.
MI symptoms
dyspnoea, sweating, anxiety, nausea, faitness. chest pain.
how are palpitations often described
the unexpected awareness of the heartbeat.
if someone says they have palpitations what shouold you always do
ask them to describe what they mean and to tap it out. irregularly irregular suggests A fib.
full hx inc socrates for HPc. risk factors. anxiety. thyrotoxicosis. a full Hx will cover most bases.
palpitations associations
anxiety, coffee etc, exercise, terminated by swallowing or coughing (valsalva). syncope (VT).
endocrine problem that can cause palpitations
thyrotoxicosis - ask about weight loss, heat intolerance, increased stool frequency or irritability.
