Clinical features of heart disease

Question 1

What are common symptoms that occur with heart disease?

Answer 1

• Chest pain
• Dyspnoea
• Palpitations
• Syncope
• Peripheral oedema

Question 2

What causes chest pain in angina pectoris and myocardial infarction?

Answer 2

• Myocardial hypoxia

Question 3

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?

Answer 3

• angina

Question 4

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?

Answer 4

• Acute coronary syndrome

Question 5

If chest pain is severe, tearing and radiating through to the back what is the diagnosis?

Answer 5

•Aortic dissection

Question 6

If chest pain is sharp, central and central that is worse with movement or respiration but relieved with sitting forward what is the diagnosis?

Answer 6

•Pericarditis pain

Question 7

If chest pain is sharp, stabbing, left sub-mammary pain associated with anxiety what is the diagnosis?

Answer 7

• da Costa syndrome

Question 8

What is cardio related cause of dyspnoea?

Answer 8

• Left ventricular failure due to oedema of the pulmonary interstitial and alveoli.

Question 9

What other symptom is associated with dyspnoea caused by left ventricular failure?

Answer 9

• Tachypnoea

Question 10

What is orthopnoea and what causes it?

Answer 10

• 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

Question 11

What is paroxysmal nocturnal dyspnoea?

Answer 11

• 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.

Question 12

What are palpitations? Give the three type of palpitations.

Answer 12

• 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

Question 13

What is syncope?

Answer 13

• A transient loss of consciousness due to inadequate cerebral blood flow.

Question 14

What are the cardiovascular categories that causes syncope?

Answer 14

• Vascular
• Obstructive
• Arrhythmias

Question 15

What are the vascular causes of syncope?

Answer 15

• A vasovagal attack (most common)
• Postural hypotension
• Postprandial hypotension
• Micturition syncope
• Carotid sinus syncope
• Obstructive

Question 16

What are the obstructive causes of syncope?

Answer 16

• Aortic stenosis
• Hypertrophic cardiomyopathy
• Pulmonary stenosis
• Tetralogy of Fallot
• Pulmonary hypertension/embolism
• Atrial myxoma/thrombus
• Defective prosthetic valve

Question 17

What are the arrhythmic causes of syncope?

Answer 17

• Rapid tachycardias
• Profound bradychardias
• Significant pauses in rhythm
• Artificial pacemaker failure

Question 18

When can fatigue be a symptom of cardiovascular disease?

Answer 18

• 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

Question 19

How is peripheral oedema caused in cardiovascular disease?

Answer 19

• Heart failure results in salt and water retention die to renal under-perfusion and consequent activation of the renin-angiotensin-aldosterone system.