Clinical features of heart disease Flashcards
What are common symptoms that occur with heart disease?
- Chest pain
- Dyspnoea
- Palpitations
- Syncope
- Peripheral oedema
What causes chest pain in angina pectoris and myocardial infarction?
• Myocardial hypoxia
If chest pain is retrosternal heavy or gripping snesation with radiation to the left arm or neck that is made worse by exertion and eases with rest or nitrates what is the diagnosis?
• angina
If chest pain is retrosternal heavy or gripping snesation with radiation to the left arm or neck and is present at rest what is the diagnosis?
• Acute coronary syndrome
If chest pain is severe, tearing and radiating through to the back what is the diagnosis?
•Aortic dissection
If chest pain is sharp, central and central that is worse with movement or respiration but relieved with sitting forward what is the diagnosis?
•Pericarditis pain
If chest pain is sharp, stabbing, left sub-mammary pain associated with anxiety what is the diagnosis?
• da Costa syndrome
What is cardio related cause of dyspnoea?
• Left ventricular failure due to oedema of the pulmonary interstitial and alveoli.
What other symptom is associated with dyspnoea caused by left ventricular failure?
• Tachypnoea
What is orthopnoea and what causes it?
- breathlessness on lying flat
- Blood is redistributed from the legs to the torso, leading to an increase in central and pulmonary blood volume.
- Patients use an increasing number of pillows to sleep
What is paroxysmal nocturnal dyspnoea?
- Patient is woken from sleep due to breathlessness
- It is caused by the same mechanisms as orthopnoea, however, as sensory awareness is reduced whilst asleep, the pulmonary oedema can become severe.
What are palpitations? Give the three type of palpitations.
- An increased awareness of the normal heart beat or the sensation of the slow, rapid or irregular heart rhythms.
- Premature beats (ectopics) / Paroxymal tachycardias / Bradycardias
What is syncope?
• A transient loss of consciousness due to inadequate cerebral blood flow.
What are the cardiovascular categories that causes syncope?
- Vascular
- Obstructive
- Arrhythmias
What are the vascular causes of syncope?
- A vasovagal attack (most common)
- Postural hypotension
- Postprandial hypotension
- Micturition syncope
- Carotid sinus syncope
- Obstructive
What are the obstructive causes of syncope?
- Aortic stenosis
- Hypertrophic cardiomyopathy
- Pulmonary stenosis
- Tetralogy of Fallot
- Pulmonary hypertension/embolism
- Atrial myxoma/thrombus
- Defective prosthetic valve
What are the arrhythmic causes of syncope?
- Rapid tachycardias
- Profound bradychardias
- Significant pauses in rhythm
- Artificial pacemaker failure
When can fatigue be a symptom of cardiovascular disease?
- Inadequate systemic perfusion in heart failure
- Due to poor sleep
- Side-effect of medication (beta-blockers)
- Electrolyte imbalance caused by diuretic therapy
- Systemic manifestation of infections, e.g. endocarditis
How is peripheral oedema caused in cardiovascular disease?
• Heart failure results in salt and water retention die to renal under-perfusion and consequent activation of the renin-angiotensin-aldosterone system.
