Cardiovascular Screening Flashcards
Cardinal Symptoms of Cardiac Disease
- Chest, neck, arm pain
- palpitation
- dyspnea
- syncope
- fatigue
- diaphoresis
- cyanosis
Heart spinal segments
C3-T4
-can have referred to these somatic areas with heart issues
Patient describes a bump, pound, jump, flop, flutter, or racing heart
palpitation
If you have palpitation w/ family Hx of sudden death..
immediate medical referral
Reffered to as breathlessness or shortness of breath
dyspnea - can have cardiovascular origin
-often caused by left ventricle that is unable to fully contract
Shortness of breath and Paroxysmal Nocturnal Dyspnea suggest…
CHF
-if you can’t climb a flight of stairs without SOB then a referral is likely necessary
Arrhythmias, orthostatic hypotension, poor ventricular functioning, CAD, and vertebral artery issues all can cause…
Cardiac Syncope
-referral or further investigation is needed especially if it occurs w/o warning
What is a good way to monitor fatigue?
Vital signs
-often BP will not rise with increasing exercise if it is of cardiac origin
Edema in the form of a 3-pound or greater gain in ankles, abdomen, or hands combined w/ SOB, fatigue suggests…
Major red flag of progressive CHF
Most common CV conditions to mimic MS dysfunction are…
angina, MI, pericarditis, dissecting aortic aneurysm
Myalgia and myopathy may result from this medication…
Statins…
- are used for LDL cholesterol
- risk is highest for those w/ liver disease, acute infection, hypothyroidism
Involves hardening of the arteries and plaque buildup, ultimately leading to ischemia and necrosis
Atherosclerosis
-symptoms may not show until the lumen of coronary artery narrows by 75%
While 1 in 30 women deaths occur from breast cancer, 1 in 2.5 deaths occurs from…
Heart Disease
-symptoms are felt differently for women than men often described as breathing cold air, SOB, weakness, lethargy
Results from imbalance between cardiac workload and oxygen supply to myocardial tissue…
Angina.
- Multiple types…chronic stable, resting, unstable, nocturnal, atypical, prinzmetal’s
- most often seen as left shoulder pain, chest pain, neck, jaw, teeth pain
Squeezing, burning, pressing, choking, aching, bursting describes what type of pain….
Angina
- often feels like gas or heartburn
- should only last 1-3 minutes
- rest or nitroglycerine (vasodilation) helps
Coronary occlusion leads to what is called…
MI
When is MI most common?
Morning. Its when the clotting system is active, BP surges, HR increases. Stress hormones are also increased in the morning
-also tends to occur when working with arms overhead
Sudden loss of responsiveness, no normal breathing, and no signs of circulation indicate…
Sudden Cardiac Arrest
Severe fatigue, chest or radiating pain, pallor, profuse sweating, nausea, vomiting suggest…
MI
May initially have no signs or symptoms. Progress to chest pain and dyspnea, increased HR, rise in temp, malaise, myalgia, pain worse w/ breathing or trunk movements
Pericarditis - inflammation of the pericardium
Described as the physiological state in which heart is unable to pump enough blood to meet metabolic needs…
CHF
-usually will see SOB, swelling, fatigue, weakness, cough, orthopnea, pulmonary edema, cerebral hypoxia, cramping
Failure of one ventricle in CHF is usually followed by failure of the other. This is called…
Ventricular Interdependence
A condition in which the left ventricle stiffens and hypertrophies, thus unable to fill completely leading to decreased output…
Diastolic Heart Failure
Results when vessel or heart wall becomes weakened from trauma, congenital conditions, infection, or atherosclerosis…
Aneurysm
- can be thoracic or peripheral
- HTN is a big risk factor
- abdominal > thoracic
Marfan Syndrome, Loeys-Dietz Syndrome, Turner Syndrome, Vascular Ehlers-Danlos Syndrome all predispose patient to…
Aneurysm
-also any anterior orthopedic spinal procedures predispose as well
Feeling of heartbeat in abdomen or back pain described as sharp, intense, severe, or knifelike…
Abdominal aortic aneurysm
- risk of rupture approaches 25% for AAAs that are 6.0cm.
- should palpate then auscultate for bruits
- abdominal aorta passes by T12 then bifurcates
Stenosis, Insufficiency, and Prolapse all describe issues of what cardiac structure…
Valves!!
-often these people are asymptomatic. Needs extensive auscultation to differentiate.
Often is a child or young adult w/ recent cold or sore throat for 3 weeks and painful migration of symptoms to joints. Also fever, fatigue, malaise, weakness…
Rheumatic Fever
-can have a chronic effect on heart valves
Bacterial endocarditis causes inflammation of the cardiac endothelium but may also cause…
Tricuspid, aortic, or mitral valve damage.
-may see MS arthralgias, 1/3 have LBP, and may present like herniated disk w/ radiculopathy
Characterized by mitral leaflet thickness w/ increased extensibility, decreased stiffness, and decreased strength…
Mitral Valve Prolapse
- likely congenital
- asymptomatic in isolation. Symptoms usually due to imbalance in ANS called dysautonomia
Profound fatigue not attributed to exercise or stress, cold hands and feet, SOB, chest pain, palpitations all suggest…
Mitral Valve Prolapse
Clients who are neurologically unstable may be susceptible to…
cardiac arrhythmias
-these patients should have vitals measured carefully during exercise
People with _____ are at greater risk of clot migration, especially if on blood thinners
A-Fib - can increase risk of stroke or heart failure
- at risk if previous MI, high BP, CHF, pericarditis, rheumatic mitral stenosis, excessive thyroid hormone, excess alcohol or caffeine consumption, high fevers
- S/S dizziness, chest pain, fainting
_____ would suggest vessels cannot relax fully and remain somewhat constricted requiring the heart to work harder
HTN - is often in conjunction with PAD
- major risk factor for cardiac disease
- risk is varied with measurements but also risk factors including family Hx
_____ describes elevated BP in doctor office
_____ describes lower BP in doctor office
White-coat HTN
Masked HTN
Stress, diet, exercise, obesity all represent _____
modifiable risk factors of HTN
TIA stands for ______
Transient Ischemic Attack
- may last as long as 24 hrs to just minutes
- are important warning signals that obstructions exist. they are predictors of stroke.
_____ refers to intermittent episodes during which small arteries or arterioles in extremities constrict, causing temporary pallor and cyanosis of the digits and changes in skin temperature
Raynaud’s Syndrome
-is a vasospastic or vasomotor disorder
Acute venous disorders are caused by the formation of what?
Thrombi or clots
- this could be DVT in leg
- caused by venous stasis, hypercoagulability (may accompany malignant neoplasms), or injury to venous wall
Appear red, raised, warm, tender, maybe fever, chills, malaise, often in the LE
DVT
+ Homan’s sign (insensitive and nonspecific)
should get an ABI
Identified by swollen limbs, thick and course brownish skin around ankles, and possible venous ulceration
Postphelbitic Syndrome - also known as chronic venous disorders - monitored for life
Increased levels of potassium can cause _____
arrhythmias and asystole
Sodium levels will typically drive ______
swelling or diuresis
-vomiting, diarrhea, or excessive diaphoresis can cause this to decrease
A decrease in _____ results in myocardial irritability and cardiac arrhythmias
Magnesium
NSAIDs have the ability to negate the ________ of ACE inhibitors
antihypertensive effects
Diuretics help lower BP but have SE of ______
muscle weakness, spasms, dizziness, headache, incoordination, and nausea
These drugs work to relax the blood vessels and heart muscle by binding to ______ on the SA node and myocardial cells, lowering force of contraction and HR
Beta-Blockers
beta receptors
Fainting w/o warning
Cardiac Red Flag
cannot climb single flight of stairs w/o being severely winded
Cardiac Red Flag
Palpitation with a history of unexplained sudden death in family
Cardiac Red Flag
Neurologically unstable patients
Cardiac Red Flag
-possible for arrhythmias
Nitroglycerin does not relieve angina pain
Cardiac Red Flag
Abnormally severe chest pain w/ nausea and vomiting
Cardiac Red Flag
Radiating angina pain and angina pain that is not relieved by rest
Cardiac Red Flag
anyone w/ coronary stent experiencing chest pain
Cardiac Red Flag
difference of more than 40 mmHg in pulse pressure
Cardiac Red Flag
Women w/ chest or breast pain who have a positive family Hx
Cardiac Red Flag
Anyone w/ trigger points should also be evaluated for _____
Trigger points
Upper quadrant pain that can be reproduced by lower quadrant activity suggests ______
cardiac origin
Back pain which looks like herniated disk but no neuro S/S suggests ______
Endocarditis
3 P’s
Pleuritic Pain
Pain on Palpation
Pain with changes in Position
if there are 2/3 of these present, an MI is very unlikely
