CLIN Cardiovascular Hx

Question 1

Process of CARDIO Hx

Answer 1

• Chest pain/heaviness
  o Have you experienced chest pain? Is it worse with exertion?
• Dyspnoea (Exertional dyspnoea)
  o Have you experienced shortness of breath? Is it worse with exertion?
• Paroxysmal nocturnal dyspnoea
  o Do you wake in the night short of breath?
• Orthopnoea
  o Do you get breathless lying flat? How many pillows do you sleep on?
• Ankle swelling
  o Have you noticed any ankle swelling? Is it worse at a particular time of the day?
• Palpitations (abnormal awareness of one’s heart beats)
  o Have you experienced palpitations? Are they associated with chest pain, dizziness, shortness of breath or LOC?
   Can ask pts to tap it out…
• Intermittent claudication
  o Do you ever get pain in your legs when walking? Change in distance able to walk? Does it stop quickly?
• Syncope (fainting)
  o Do you ever feel dizzy? Have you ever fainted? Associated symptoms before & after (incl. aura)?
• Fatigue
  o Have you been more tired lately?

Question 2

What defines cardiovascular disease?

Answer 2

All diseases/conditions of the heart & blood vessels.

Question 3

Possible causes of chest pain

Answer 3

Ischaemic - MI/angina pectoris
Non-ischaemic - aortic dissection/pericarditis

Question 4

Characteristic of chest pain due to MI

Answer 4

Recent onset, comes at rest, more severe than angina, > 30 minutes, associated w dyspnoea, sweating, anxiety, nausea, feeling of impending death.

Question 5

Characteristic of chest pain due to angina pectoris

Answer 5

Retrosternal anterior chest discomfort, crushing, tightening, squeezing, pressure sensations, 2-20 mins, may radiate to neck, jaw, arms, shoulders, pain brought on by exertion, emotional stress, heavy meals, cold air, relieved by rest/sublingual nitroglycerin.

Question 6

Characteristic of chest pain due to aortic dissection

Answer 6

Abrupt onset, very severe, tearing/ripping sensation, central to the chest, radiates to the back, persists for hours.

Question 7

Characteristic of chest pain due to pericarditis.

Answer 7

Stabbing or burning character, not brought on by exertion, aggravated by coughing, deep breathing, lying down, relieved by leaning forwards.

Question 8

What may dyspnoea be a symptom of?

Answer 8

Heart failre, aortic stenosis.

Question 9

What may orthopnea by a sympom of?

Answer 9

Heart failure.

Question 10

What may PND by a symptom of?

Answer 10

Left-heart failure.

Question 11

Characteristic of intermittent claudication

Answer 11

Pain in the muscles of the lower limbs associated with walking, relieved by rest, pain located to calf muscles, aching/cramping.

Question 12

Cardiac causes of syncope

Answer 12

Arrhythmias, valvular stenosis.

Question 13

What may ankle oedema be a symptom of?

Answer 13

Right/left-sided heart failure, chronic congestive heart failure.

Question 14

What may fatigue be a symptom of?

Answer 14

Congestive heart failure, inadequate cardiac output.