Cardiovascular - Symptoms and Definitions Flashcards
Most common type of cardiac chest pain
Angina pectoris
Main three causes of angina
Myocardial ischaemia caused by
1) Obstructed coronary vessel (most commonly)
2) Aortic stenosis in increased O2 demand
3) Hypertrophic cardiomyopathy in increased O2 demand
Hoe can stable angina be relieved?
Rest and GTN
Common symptoms of heart disease
- Chest discomfort
- Breathlessness
- Palpitation
- Syncope/dizziness
- Oedema
Causes of chest discomfort
CV causes
- MI
- Angina
- Pericarditis
- Aortic dissection
Other causes
- Oesophageal spasm
- Pneumothorax
- MSK pain
Causes of breathlessness
CV causes
- Heart failure
- Angina
- PE
- Pulmonary hypertension
Other causes
- Resp disease
- Anaemia
- Obesity
- Anxiety
Causes of palpitation
CV causes
- Tachyarrythmias
- Ectopic beats
Other causes
- Anxiety
- Hyperthyroidism
- Drugs
Causes of syncope
CV causes
- Arrhythmias
- Postural hypotension
- Aortic stenosis
- Hypertrophic cardiomyopathy
- Atrial myxoma
Other causes
- Simple faints
- Epilepsy
- Anxiety
Causes of oedema
CV causes
- Heart failure
- Constrictive pericarditis
- Venous stasis
- Lymphoedema
Other causes
- Nephrotic syndrome
- Liver disease
- Drugs
- Immobility
Characteristics of chest pain attributed to an Aortic dissection
Site: Interscapular / retrosternal Onset: very sudden Character: tearing / ripping Radiation: back between shoulders Associated features: sweating, syncope, focal neuro signs, signs of limb ischaemia, mesenteric ischaemia Timing: Prolonged Exacerbating factors: Spontaneous Relieving factors: no manouvres relieve pain Severity: Very severe
Cause: Thoracic aorta dissection rupture
Characteristics of chest pain attributed to Pericardium
Site: Retrosternal or left-sided
Onset: gradual, postural change may suddenly aggravate
Character: sharp, stabbing, pleuritic
Radiation: left shoulder or back
Associated features: fever, breathlessness, flu-like
Timing: Prolonged
Exacerbating factors: Pleuritic, lying down may intensify
Relieving factors: NSAIDs can help
Severity: Can be severe
Cause: pericarditis - usually viral post MI
orthopnoea
dyspnoea on lying flat
What are the five types of arrhythmias
Extrasystoles Sinus Tachycardia Supraventricular Tachycardia Atrial fibrillation Ventricular tachycardia
When should a patient with heart palpitations be urgently investigated?
- MI, PCI, or cardiac surgery within last 3 months,
- associated syncope or severe chest pain
- family Hx of syncope or sudden death
- Wolff-Parkinson-White syndrome or inherited channelopathy, e.g. long QT syndrome
- Significant structural heart disease, e.g. hypertrophic cardiomyopathy, aortic stenosis
