Cardiovascular symptoms and cardiovascular conditions Flashcards
What is an acute coronary syndrome?
The classic description of chest pain due to acute coronary syndrome that may lead to myocardial infarction. Sever, central, retrosternal, crushing or heavy pain that comes on over minutes at rest. May present as heartburn or indgestion. Can radiate to arms, throat, jaw or teeth. Associated with dyspnoea, sweating, anxiety (impending doom), nausea or vomiting. Not relieved by sublingual GTN.
It is caused by atherosclerosis in the coronary arteries. The artery becomes occluded when a coronary artery plaque ruptures or erodes and this leads to severe ischemia.
What is angina?
Pain which is precipitated by exercise, and is a dull discomfort like a pressing tight band or a heavy weight. It is relieved by rest. It is rapidly relieved by sublingual GTN. Can be felt in the anterior chest, can radiate to arms, throat or jaw. PND: nightly attacks of breathlessness.
Angina is caused by atheroma or spasm in the coronary arteries.
What is claudication?
Ischemic pain in the muscles of the leg. Can feel like a crushing, vice like pain in one or both calves when walking. Relieved by rest. This is due to peripheral vascular disease and is commonly associated with ischemic heart disease or cerebrovascular disease.
What is dyspnoea? What is orthopnea and paroxysmal nocturnal dyspnoea?
Short of breath. A good question to ask is how well they cope with climbing a flight of stairs. Orthopnea: shortness of breath when lying flat. Occurs with left ventricular failure and redistribution of collected fluid in the lungs causing more widespread lung stiffness, particularly in the upper lobes. This person may need more pillows to sleep.
What is oedema?
Collection of fluid in the interstitial space.
Right heart failure precipitates peripheral oedema, which is most often noticed in the ankles and sacrum.
Pulmonary oedema is due to left ventricular failure with dyspnoea, orthopnea or PND.
Unilateral lower limb oedema can occur in DVT where the thrombus is in a venous system causing oedema.
What are palpitations?
Unexpected or unpleasant awareness of heartbeat which may be explained by ‘butterflies in chest’ or ‘feeling my heart thumping’.
Might be an arrhythmia such as atrial fibrillation, ventricular fibrillation or supraventricular tachycardia.
Palpitations may be associated with caffeine, alcohol, anxiety etc.
What is syncope and pre-syncope?
Fainting: transient loss of consciousness resulting from cerebral anoxia, usually due to inadequate blood flow.
Can be from arrhythmia, sudden emotional stress (vasovagal syncope).
What is a myocardial infarction?
Cardiac myocytes die due to myocardial ischemia that can occur when acute coronary syndrome is not recognised or treated. It presents in the same way as acute coronary syndrome. Can be treated with PCI (percutanous coronary intervention) or fibrinolytic. MI can lead to heart failure.
What is hypertension?
Chronic high blood pressure which is asymptomatic. HTN can cause arrhythmias, heart failure and vascular disease.
What is heart failure?
Reduction in cardiac function to the extent that blood flow is compromised, leading to the signs and symptoms of heart failure.
What is right heart failure and what can cause it?
Presentation of oedema, abdominal swelling, weight gain, increased urination, anorexia and nausea.
Causes: COPD (chronic lung disease), severe left ventricular failure, volume overload (atrial septal defect, primary tricuspid regurgitaiton), pressure overload (pulmonary stenosis, idiopathic pulmonary hypertension), myocardial disease (right ventricular infarction).
What is left heart failure and the causes?
Presentation: shortness of breath on exertion, orthopnea, PND, may have cough and fatigue.
Causes: myocardial disease (ischemic heart diseased), volume overload (aortic regurgitation, mitral regurgitation), pressure overload (hypertension or aortic stenosis), rapid arrhythmia (atrial fibrillation), anemia.
Presentation of atrial fibrillation?
Shortness of breath on exertion, reduced exercise tolerance, fatigue, palpitations.
May present with symptoms of cerebrovascular disease (stroke) due to embolus from the atrium.
Sometimes they can be asymptomatic.
Aortic stenosis presentation?
The patient can present with breathlessness, chest pain or tightness with exertion, presyncope or syncope.
