Chest Symptoms: Common Presentations Flashcards
SOB exploding symptoms
Exertional tolerance
-improved on rest?
Orthopnea and PND - how many pillows do you sleep with
Triggers - allergies? medications?
MI symptoms?
Possible differentials for SOB
Asthma, COPD
Chest infection, pneumonia
IPF
Lung cancer
Heart failure
Angina
Anemia
Cough exploding symptoms
Productive?
Dry? - IPF, sarcoidosis? Viral infection?
Purulent? - bacterial? pneumonia?
Blood - cancer, TB
Triggers
- night, cold air, aspirin, NSAIDs, exercise, irritants => asthma?
- food => GERD vapour?
Possible differentials for cough
Asthma, COPD Pneumonia, URTI IPF, sarcoidosis Lung cancer Pulmonary edema
GERD vapour
Sputum exploding symptoms
-possible differentials
How much, how often?
Colour?
- green - bacterial infection?
- white, foamy - COPD?
Blood? - TB, cancer?
Blood exploding symptoms
-possible differentials
RED FLAG FOR TB, CANCER
Volume
Fresh or old?
Frequency?
Palpitations exploding symptoms
Fast or slow? - type of arrythmia
Regular or irregular?
Reduced head perfusion - dizziness, LOC
Reduced cardiac perfusion - nausea, sweating, SOB?
Key symptoms to ask in a cardioresp systems review
SOB Chest pain - pleuritic/dull Cough - productive (blood, sputum, colour) Palpitations Exercise tolerance Fainting, falls Leg pain - on exertion? sharp/dull? Leg swelling, redness? Pillows SOB at night Wheezing, additional sounds Recent travel? - PE and DVT
Possible differentials for palpitations
Cardiac
-arrythmias
Endocrine
- phareochromocytoma - chest pain, headaches, sweating, anxiety
- thyrotoxicosis - anxiety, weight loss, sweating, amenorrhea
- menopause - mood changes, irregular periods
Psych
-anxiety, panic attacks
Past medical history
- key questions
- examples of relevant CV conditions and medications
Do you have any medical conditions that you’re managing
How are you managing them
Any past surgeries, procedures, hospital visits?
Have you ever been under the care of mental health services?
Are you on any other medications?
-HTN, DM, cholesterol?
Any drug allergies
Arrythmias Valve disease CHD CCF Cardiomyopathy
Bb
Statins
ACEi, ARB, diuretics
Family history
-key questions
Are there any health conditions that run in your family?
Is there a history of heart problems in your family?
Social history
-key questions
Living
- who is at home with you?
- what kind of accommodation do you live in?
- do you have caring responsibilities?
- do you receive support from a carer?
- are you able to carry out all your activities of daily living?
Occupation
- are you in work, what do you do?
- has your PC affected your ability to work
- do you drive to work?
Substances
- do you smoke => pack years
- do you drink => units
- have you ever taken recreational drugs?
- what’s your diet like?
Travel
-have you recently travelled?
-how much physical activity would you do in a typical week?
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