CVS History

Question 1

Describe how you would take a cardiovascular history

Answer 1

Presenting complaint, Past history of presenting complaint, past medical history, points to consider (Diabetes, hypertension ect), Drug history and allergies, Family history, social history

Question 2

How can you calculate pack years

Answer 2

(No. ciggs smoked per day x No. years smoking) / 20

Question 3

Name some non-modifiable risk factors for cardiovascular disease

Answer 3

Race and ethnicity, biological sex, Genetics and age

Question 4

Name some modifiable risk factors

Answer 4

Obesity, smoking, high blood pressure, psychosocial factors, high cholesterol and diabetes

Question 5

What symptoms can be worsened with medication?

Answer 5

Dysponea - Beta blockers. 
Dizzieness - vasodilators. 
Angina - NSAIDS
Oedema - Steroids
Palpitations - Beta2 stimultents

Question 6

What are some of the causes of chest pain?

Answer 6

CV - Aortic dissection, preicarditis, stable angina, acute coronary syndromes.
R- PE, pneumothorax, pneumonia, lung cancer
GI- oesophageal disease
MS - trauma
Shingles (herpes zoster)

Question 7

Where is the pain of aortic dissection felt? and what does the pain feel like?

Answer 7

Between scapula, tends to be a tearing or ripping feeling. It is very severe and no pain relief manoeuvres

Question 8

Describe the differences between Angina and Myocardial Infarction

Answer 8

Similar site (retrosternal which radiates to arm and neck)
AG - Brought on by exercise/emotion
MI - Spontaneous
AG- relived by rest and nitrates
MI - not relived by rest or nitrates
AG - nausea or vomiting is uncommon
MI- Nausea and vomiting are common

Question 9

Describe features of pericarditis

Answer 9

It is inflammation of the pericardium. Acute onset, pain is commonly retrosternal but can be anywhere on anterior chest, may radiate to arm but a characteristic feature is the pain can radiate to trapezius ridge

Question 10

If patient complains about Dysponea (shortness of breath) what should you ask?

Answer 10

Acute or chronic? How disabling? can you exercise? response to a diutetic? associated symptoms?
Orthoponea/PND?

Question 11

What is paroxysmal nocturnal dysponea?

Answer 11

Sensation of shortness of breath that awakes a patient, it is often relived when they stand in an upright position. Indication of left sided heart failure.

Question 12

What are the causes of dysponea?

Answer 12

CV - cardiac failure, associated with angina or MI.
R - Asthma, COPD, Pneumothorax, pneumonia
others - anxiety, anemia, obesity.

Question 13

What is orthopnea?

Answer 13

Breathlessness in the recumbent position, relived by sitting or standing

Question 14

What should you ask a patient with palpitations?

Answer 14

Ask patient to tap it out, onset and termination, precipitate/relieving factors, frequency and duration, associated symptoms, PMH

Question 15

What are some of the causes of dizziness and syncope

Answer 15

Postural hypotension, neurocardiogenic (vasovagal), micturition syncope and cardiac arrythmias, hypoglycaemic.

Question 16

What questions should you ask when a patient complains of dizziness of syncope?

Answer 16

Try establish what happened/witness, frequency and duration? loss of consciousness? and associated symptoms?

Question 17

What questions should you ask if a patient presents with oedema?

Answer 17

Localised or general? unilateral or bilateral? Is it getting better or worse? aggravating or relieving factors?

Question 18

What is pitting oedema?

Answer 18

If you press on the swollen area and then release, it will leave an indent in the skin as you moved the fluid, can be due to increased venous pressure.

Question 19

Name some of the causes of unilateral oedema

Answer 19

DVT, chronic venous insufficiency and compartment syndrome

Question 20

Name some of the causes for bilateral oedema?

Answer 20

Congestive cardiac failure, cirrhosis, acute renal failure, meds. sepsis and pregnancy.

Question 21

Name some of the cardiovascular causes of fatigue

Answer 21

Inadequate systemic perfusion in cardiac failure or potentially side effects of medication

Question 22

Name some important characteristics of left sided heart failure

Answer 22

Paroxysmal noctural dysponea, orthoponea, cyanosis and pulmonary congestion

Question 23

Name some of the key characteristics of right sided heart failure

Answer 23

Peripheral venous pressure, ascites, enlarged liver and spleen, dependent oedema and distended jugular veins