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Clinical 3001 > History Taking Cardiovascular System > Flashcards

History Taking Cardiovascular System Flashcards

1
Q

According to Dr Bernard Lown what percentage of patient encounters can be diagnosed by the medical history?

A

75%

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2
Q

What are the 5 steps of Roger Neighbour’s consultation model?

A
  1. Connecting
  2. Summarising
  3. Handing over
  4. Safety netting
  5. Housekeeping
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3
Q

What conditions may you specifically ask for in a cardiovascular examination ?

A
  • History of vascular disease
  • Diabetes
  • Hyperthyroidism
  • Renal disease
  • Hypertension
  • Hypercholesterolaemia
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4
Q

How do you calculate pack years?

A

(No. of cigarettes smoked per day X No. of years smoking) / 20

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5
Q

What should you include in a systems enquiry?

A
  • Chest pain
  • Breathlessness (including orthopnoea and paroxysmal nocturnal dyspnoea)
  • Palpitations
  • Syncope / dizziness
  • Oedema
  • Peripheral vascular symptoms
  • Intermittent claudication
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6
Q

What are modifiable cardiovascular risk factors?

A
  • High BP
  • Smoking
  • Diabetes melitus
  • Physical inactivity
  • Obesity
  • High blood cholesterol
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7
Q

What are non-modifiable cardiovascular risk factors?

A
  • Age
  • Gender
  • Genetic factors
  • Race and ethnicity
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8
Q

What are the cardiovascular causes of chest pain?

A
  • Stable angina
  • Acute coronary syndromes
  • Pericarditis
  • Aortic dissection
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9
Q

What are the respiratory causes of chest pain?

A
  • Pulmonary embolus
  • Pneumothorax
  • Pneumonia
  • Lung cancer
  • Mesothelioma
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10
Q

What GI disease can cause chest pain?

A

Oesophageal disease

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11
Q

What are the musculoskeletal causes of chest pain?

A
  • Trauma - muscular or rib injury

- Chostochondritis

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12
Q

What conditions are included in as an acute coronary syndrome?

A
  • STEMI
  • NSTEMI
  • Unstable angina
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13
Q

How do you differentiate oesophageal disease from angina pectoris

A
  • Angina can radiate pain to jaw
  • Angina is usually precipitated by exertion but oesophageal pain can be worsened but is usually present at other times
  • Angina is rapidly relieved by rest
  • Oesophageal disease often wakes patient from sleep angina rarely does
  • Angina is typically 2-10 mins
  • Oesophageal disease is related to heartburn
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14
Q

What percentage of percarditis is idiopathic?

A

80 -90%

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15
Q

How is aortic dissection pain usually described?

A
  • Sudden and severe
  • Tearing and deep
  • Radiating to left shoulder / back
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16
Q

What is dyspnoea

A

Difficulty or trouble breathing

17
Q

What are the cardiac causes of dyspnoea?

A
  • Cardiac failure

- Associated with angina or MI

18
Q

What are the causes of respiratory dyspnoea?

A
  • Asthma
  • COPD
  • Pneumothorax
  • Pneumonia
  • Bronchitis
  • Bronchiectasis
  • Pulmonary fibrosis
19
Q

What are the causes of dyspnoea that are not cardiac or respiratory related?

A
  • Anaemia
  • Obesity
  • Hyperventilation
  • Anxiety
  • Metabolic acidosis
20
Q

How can you differentiate dyspnoea?

A
  • Acute, chronic or acute-onchronic
  • At rest / on exertion / exercise tolerance?
  • Orthopnoea / paroxysmal nocturnal dyspnoea (PND)
  • Response to diuretic?
  • Associated symptoms (e.g cough / sputum / chest pain /palpitations)
21
Q

What is Paroxysmal nocturnal dyspnea (PND)?

A

A sensation of shortness of breath that awakens a patient often after 1 or 2 hours of sleep.

22
Q

What underlying conditions can cause PND?

A
  • (Heart failure)
  • Ischaemic heart disease
  • Aortic valve disease
  • Hypertension
  • Cardiomyopathy
  • Atrial fibrilation
  • Mitral valve disease
  • Atrial tumours
23
Q

What is orthopnea?

A

The sensation of breathlessness in the recumbent position, relieved by sitting or standing. Often a symptom of left ventricular heart failure and/or pulmonary oedema.

24
Q

What is a heart palpitation?

A

An unexpected awareness of heart beating in chest.

25
Q

What is postural/orthostatic hypotension?

A

When systolic blood pressure decreases by at least 20 mg Hg when going from lying down to flat

26
Q

What conditions can cause dizziness and syncope?

A
  • Postural hypotension
  • Neurocardiogenic (vasovagal)
  • Micturition syncope
  • Cardiac arrhythmias
27
Q

What is micturition syncope?

A

Fainting after urination

28
Q

What factors should you consider when assessing oedema?

A
  • Localised or generalised
  • Are the legs unilateral or bilateral
  • Duration
  • Are there any aggravating or relieving factors
29
Q

What is the most common cause of pitting oedema?

A
  • Increased venous pressure (can also result from reduced oncotic pressure or may be idiopathic)
30
Q

What conditions can cause bilateral oedema?

A
  • Congestive cardiac failure
  • Cor pulmonale
  • Cirrhosis
  • Acute renal failure
  • Medication, for example, calcium-channel blockers
  • Sepsis
  • Myxoedema
  • Pregnancy
  • Idiopathic
31
Q

What conditions can cause unilateral oedema?

A
  • DVT
  • Chronic venous insufficiency
  • Compartment syndrome
  • Retroperitoneal mass
32
Q

What is micturition syncope?

A

Fainting shortly after urination

Clinical 3001 (6 decks)

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