General Cardiovascular History

Question 1

Name all questions in presenting complaint? (10)

Answer 1

• “Do you have any chest pain?”
• “Do you ever feel breathless?”
• “Do you ever feel so breathless that you can’t lie down? How many pillows do you use?”
• “Do you ever wake up feeling breathless?”
• “Are you ever aware of your own heartbeat (palpitations)?”
• “Have you noticed any swelling in your ankles?”
• “Have you had any faints?”
• “Do you ever get cramp in your legs when you are walking that goes away when you rest?”
• “Are you finding you are getting tired easier?”

Question 2

Dyspnoea due to cardiac disease is usually…?

Answer 2

Chronic and insidious. Severity can be gauged by asking about exercise tolerance

Question 3

Presence of orthopnoea or PND implies what?

Answer 3

That condition is probably cardiac rather than respiratory

Question 4

Ankle oedema is a symptom of what? What is it characteristically like

Answer 4

Right ventricular/congestive cardiac failure.

Characteristically pitting, symmetrical and worse in the evenings.

Question 5

In bed bound patients where will oedema be found?

Answer 5

sacral rather than ankle

Question 6

How are symptoms of PAD described?

Answer 6

Pain in calves, thigh or buttocks which begins after walking a certain distance and is relieved by rest.

Question 7

What should you ask about specifically in PMH?

Answer 7

hypertension, IHD, hypercholesterolaemia, rheumatic fever, diabetes, stroke and asthma

Question 8

Why should asthma be asked about?

Answer 8

because it contra-indicates the inclusion of β-blockers in the patient’s management plan.

Question 9

What should you ask about family history?

Answer 9

• “Is there any history of MI/stroke (before the age of 65) in your family?”