History Taking: The CVS Flashcards
Describe the steps of taking a history
- presenting complaint
- history of presenting complaint
- past medical history
- drug history and allergies
- family history
- social history
- systems enquiry
What are some key things to consider asking in a cardiovascular history?
- history of vascular disease/coronary artery/cerebrovascular/peripheral vascular
- diabetes
- hyperthyroidism
- renal disease
- hypertension
- hypercholesterolaemia
What should you ask a ptient about in the systems enquiry of a cardiovascular history?
- chest pain
- breathlessness
- palpitations
- dizziness
- oedema
- peripheral vascular symptoms
orthopnoea
shortness of breath lying flat, sitting/standing relieves it
paroxysmal nocturnal dyspnoea
shortness of breath that wakes a person up 1-2 hrs after being asleep, relieved by upright position
syncope
fainting
oedema
build up of watery fluid
What are the different causes of chest pain?
- cardiovascular: angina, acute coronary syndromes, pericarditis, aortic dissection
- respiratory: pulmonary embolus, pneumothorax, pneumonia, lung cancer, mesothelioma
- upper GI: oesophageal disease
- musculoskeletal: trauma
Distinguishing angina from MI
angina is usually brought on by exercise or emotion, causes mild anxiety and doesn’t cause vomiting, this is the opposite for MI
Distinguishing angina from oesophageal disease
angina is relieved by rest and doesn’t wake a patient up from sleep from the pain, this is the opposite for oesophageal disease
What feature of chest pain is specific for pericarditis?
radiation of the pain to the trapezius ridge
Different causes of dyspnoea
- cardiac: cardiac failure, angina/MI
- respiratory: asthma, COPD, pneumothorax, pneumonia, bronchitis, pulmonary fibrosis
- other: anaemia, obesity, hyperventilation, anxiety, metabolic acidosis
What does bilateral oedema signify?
- systemic cause
What does unilateral oedema signify?
- local pathology
examples of causes of bilateral oedema?
- congestive heart failure
- cirrhosis
- acute renal failure
