Evaluation of Cardiac Symptoms Flashcards
The Typical Cardiac Patient/common cardiac symptoms
List 4
Chest pain
Palpitations
Exertional dyspnea
Hypotension/shock/syncope
Differential diagnosis of Chest pain
Cardiac:
____________
____________
_____________
_______________
Myocardial infarction
Angina
Pericarditis
Prolapse of the mitral valve
Differential diagnosis of Chest pain
Vascular :
_______________
______________
Aortic dissection
Aortic aneurysm
Differential diagnosis of Chest pain
Respiratory :
____________
____________
_____________
_______________
_______________
_____________
Pneumonia
Pneumothorax
Pulmonary embolus
Pulmonary neoplasm
Tuberculosis
Pleuritis
Differential diagnosis of Chest pain
Gastrointestinal
____________
____________
_____________
_______________
______________
_______________
GERD
PUD
Esophageal tear
Biliary disease
Pancreatitis
Esophagitis
Differential diagnosis of Chest pain
Musculoskeletal
____________
____________
_____________
_______________
Costochondritis
Fractured rib
Cervical root compression
Osteoarthritis
Differential diagnosis of Chest pain
Neurological :
_______________
______________
Herpes zoster
Thoracic outlet syndrome
Differential diagnosis of Chest pain
Psychological:
____________
____________
_____________
_______________
Panic attack
Anxiety disorders
Cocaine abuse
Myocardial ischemia:
Character of chest pain
Site
Radiation
Agg and All. Factors
Crushing
Central anterior chest
Throat, jaw, arms
Exertion, anxiety, cold ; rest, GTN
Pericarditis :
Character of chest pain
Site
Radiation
Agg and All. Factors
Sharp/Crushing
Central anterior chest
No radiation
Lying back; sitting forward
Pleuritic pain:
Character of chest pain
Site
Radiation
Agg and All. Factors
Sharp
Anywhere but localized
No radiation
Breathing, coughing, moving ; not breathing
GI pain:
Character of chest pain
Site
Radiation
Agg and All. Factors
Burning
Central
Throat
Gall bladder and esophageal pain are exacerbated by food; PUD pain is relieved by food and antacids
Musculoskeletal :
Character of chest pain
Site
Radiation
Agg and All. Factors
Sharp/dull
Anywhere
Arms/ chest to back
Pressing on chest wall or moving neck
Aortic dissection :
Character of chest pain
Site
Radiation
Agg and All. Factors
Sharp stabbing tearing
Retrosternal
No radiation
Constant pain, No Agg or All
ischemia cardiac chest pain VS non-cardiac
Character of chest pain
Site
Radiation
Agg factors
All. Factors
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
Palpitations
Is the ____________________
Could be objective, suggesting a ________ cause or from a ______ cause
Could be subjective (_________ )
Awareness of one’s heart beat
cardiac; systemic
anxiety
Medically objective palpitation is termed ______________
arrhythmia
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
Difficulty in breathing
Difficulty not expected
heart muscle
Approach to chronic dyspnea
Pulmonary:
_________
__________
____________
______________
________________
Pleura
Alveoli
Airways
Interstitium
Vessels
Approach to chronic dyspnea
Cardiovascular :
_________
__________
____________
______________
______________
Pericardium
Myocardium
Valves
Conduction system
Vessels
Dyspnea is considered acute when it develops over ________ to ________ and chronic when it occurs for more than ________ to ________
hours to days
four to eight weeks.
Syncope
(Gradual or Sudden?), (transient or prolonged?) , self-limited _____________
A major cardiac symptom
Other organ-systems can cause syncope
Sudden; transient
loss of consciousness
Differential diagnosis of syncope
Non cardiac VS cardiac
Neurocardiogenic, orthostatic hypotension , neurologic
Structural arrythmia
