Evaluation of Cardiac Symptoms

Question 1

The Typical Cardiac Patient/common cardiac symptoms

List 4

Answer 1

Chest pain
Palpitations
Exertional dyspnea
Hypotension/shock/syncope

Question 2

Differential diagnosis of Chest pain

Cardiac:

____________
____________
_____________
_______________

Answer 2

Myocardial infarction
Angina
Pericarditis
Prolapse of the mitral valve

Question 3

Differential diagnosis of Chest pain

Vascular :

_______________
______________

Answer 3

Aortic dissection
Aortic aneurysm

Question 4

Differential diagnosis of Chest pain

Respiratory :

____________
____________
_____________
_______________
_______________
_____________

Answer 4

Pneumonia
Pneumothorax
Pulmonary embolus
Pulmonary neoplasm
Tuberculosis
Pleuritis

Question 5

Differential diagnosis of Chest pain

Gastrointestinal

____________
____________
_____________
_______________
______________
_______________

Answer 5

GERD
PUD
Esophageal tear
Biliary disease
Pancreatitis
Esophagitis

Question 6

Differential diagnosis of Chest pain

Musculoskeletal

____________
____________
_____________
_______________

Answer 6

Costochondritis
Fractured rib
Cervical root compression
Osteoarthritis

Question 7

Differential diagnosis of Chest pain

Neurological :

_______________
______________

Answer 7

Herpes zoster
Thoracic outlet syndrome

Question 8

Differential diagnosis of Chest pain

Psychological:

____________
____________
_____________
_______________

Answer 8

Panic attack
Anxiety disorders
Cocaine abuse

Question 9

Myocardial ischemia:

Character of chest pain
Site
Radiation
Agg and All. Factors

Answer 9

Crushing
Central anterior chest
Throat, jaw, arms
Exertion, anxiety, cold ; rest, GTN

Question 10

Pericarditis :

Character of chest pain
Site
Radiation
Agg and All. Factors

Answer 10

Sharp/Crushing
Central anterior chest
No radiation
Lying back; sitting forward

Question 11

Pleuritic pain:

Character of chest pain
Site
Radiation
Agg and All. Factors

Answer 11

Sharp
Anywhere but localized
No radiation
Breathing, coughing, moving ; not breathing

Question 12

GI pain:

Character of chest pain
Site
Radiation
Agg and All. Factors

Answer 12

Burning
Central
Throat
Gall bladder and esophageal pain are exacerbated by food; PUD pain is relieved by food and antacids

Question 13

Musculoskeletal :

Character of chest pain
Site
Radiation
Agg and All. Factors

Answer 13

Sharp/dull
Anywhere
Arms/ chest to back
Pressing on chest wall or moving neck

Question 14

Aortic dissection :

Character of chest pain
Site
Radiation
Agg and All. Factors

Answer 14

Sharp stabbing tearing

Retrosternal

No radiation

Constant pain, No Agg or All

Question 15

ischemia cardiac chest pain VS non-cardiac

Character of chest pain
Site
Radiation
Agg factors
All. Factors

Answer 15

Tight , squeezing , choking ; sharp , burning, tearing

Central,diffuse ; periphral ,localized

Jaw neck shoulder arm ; others or no radiation

Exertion and emotion; spontaneous,respiration etc

Rest, nitrates ; not relieved by rest,slow response to nitrates

Question 16

Palpitations

Is the ____________________

Could be objective, suggesting a ________ cause or from a ______ cause

Could be subjective (_________ )

Answer 16

Awareness of one’s heart beat

cardiac; systemic

anxiety

Question 17

Medically objective palpitation is termed ______________

Answer 17

arrhythmia

Question 18

Exertional Dyspnea

__________________ on exertion

______________ for the level of exertion

Usually due to _________ disease and dysfunction from a variety of causes

There are many other non-cardiac causes

Answer 18

Difficulty in breathing

Difficulty not expected

heart muscle

Question 19

Approach to chronic dyspnea

Pulmonary:

_________
__________
____________
______________
________________

Answer 19

Pleura
Alveoli
Airways
Interstitium
Vessels

Question 20

Approach to chronic dyspnea

Cardiovascular :

_________
__________
____________
______________
______________

Answer 20

Pericardium
Myocardium
Valves
Conduction system
Vessels

Question 21

Dyspnea is considered acute when it develops over ________ to ________ and chronic when it occurs for more than ________ to ________

Answer 21

hours to days

four to eight weeks.

Question 22

Syncope

(Gradual or Sudden?), (transient or prolonged?) , self-limited _____________

A major cardiac symptom

Other organ-systems can cause syncope

Answer 22

Sudden; transient

loss of consciousness

Question 23

Differential diagnosis of syncope

Non cardiac VS cardiac

Answer 23

Neurocardiogenic, orthostatic hypotension , neurologic

Structural arrythmia