Signs and symptoms of HD Flashcards
Define the 6 types of HD
- CAD (ischaemic HD)
- Valvular HD
- Congenital HD
- Myocardial HD
- Pericardial HD
- Hypertensive HD
Describe the signs of HD
Appearance, clubbing of hands & fingers, cyanosis, peripheral oedema (limbs),
Chest deformities, pigeon chest, swelling
Skin temperatures, pale, washed out, clammy
Heart rhythm and rate, arrythmias, pulse
Describe peripheral oedema
refers to the accumulation of fluid in the lower extremities (lower limbs), Fluid accumulation is a result of HF, kidney/ liver dysfunction or poor circulation.
It can occur as a side effect of some medications or staying immobile in a position, swelling is noticeable and can lead to bed sores & pressure ulcers from poor circulation
Describe Xanthelasma
Refers to yellowish fatty cholesterol deposits around eyes , it can form small raised plaques under the skin.
Their presecence indicates high cholesterol or lipid levels, it is harmless but indicates an underlying condition. Most common in females
Describe retinopathy
Refers to a condition as a result of damage to the retina, this affects vision & can cause blindness.
It can be caused by hypertensive retinopathy which is where the there is damage to BV’s of the retina due to hypertension
Describe JVP
This refers to jugular venous pressure which is the pressure of the jugular veins in the head and neck, as pressure increases JVP becomes distended.
JVP provides info on right atrial pressure and can indicate heart function. Pulsations in JVP can provide info on right atrium pressure. Elevated JVP indicates right side HF or other circulatory issues.
To determine extent of JVP distension, JVP pulsation is measured when a patient lies at a 30-45 degree angle
Define a murmur
Any abnormal acceleration or deceleration of blood through the heart, related to the cardiac cycle.
LUB DUB is normal sound we expect to hear, any other sounds may indicate abnormalities
Name the types of murmurs
- Ejection type: caused By A & P stenosis
- Pansystolic: Caused by valvular regurgitation & VSD
- Late systolic: Caused by mitral valve prolapse
- Early crescendo: Caused by Aortic & pulmonary regurgitation
- Mid-to-late: Caused by Mitral/tricuspid stenosis
- Prolonged mid-to-late: Caused by Severe M/T stenosis
Describe the symptoms of HD
- Angina/Chest discomfort: can be triggered by exercise/stress
- SOB: during rest or at exertion can indicate HF
- Palpitations: irregular HB may indicate arrythmias
- oedema: Swelling in limbs can indicate HF
What are the 4 main causes of chest pain?
- Angina
- Unstable angina
- Myocardial infarction (MI)
- Non-cardiac cause
Define angina
Chest pain caused by reduced blood flow to the Myocardium, it occurs when myocardium does not receive enough oxygenated blood. It can occur due to atherosclerosis.
It can be triggered by exercise, heavy metals or stress.
Treatment of nitroglycerin
Define unstable angina
A more severe form of angina that last for a longer period, it can occur at rest or during exertion. It could indicated an impending MI. Pain is intense & frequent. It does not respond to meds and needs immediate treatment.
Define a myocardial infarction
Also known as a heart attack, occurs due to a blockage/near blockage, this creates reduced blood flow to the myocardium.
This can lead to tissue damage/necrosis of the myocardium. This forms scar tissue which can no longer contract/
Symptoms: SOB, Angina & sweating
It requires immediate medical attention
Describe a non-cardiac cause for chest pain
Chest pain may not originate from the heart:
e.g.,
1. GERD: Gastroesophagal reflux disease which is acid reflux that can cause burning chest pain, can be mistaken for an MI
2. Musculoskeletal pain, strained muscles or inflammation can cause sharp localised pain
3. P.E, a clot in the lungs can lead to SOB & chest pain, similar to MI symptoms
4. Panic/anxiety, Psychological conditions can trigger chest pain, often accompanied by a feeling of impending doom, rapid heart rate, and shortness of breath.
What can SOB indicate?
It can indicate Dyspnea, orthopnoea, PND, haemoptysis and dry cough,
Define dyspnea
refers to SOB sensation, commonly described as breathlessness, it can be cause by exertion, anxiety. stress & heart diseases
Define Orthopnoea
Refers to difficulty breathing when lying down, so have to sit up to relieve breathlessness. It is associated with HF/ cardiovasc diseas.
When lying down the condition worsens as fluid builds up
Define Paroxysmal nocturnal dyspnoea
A condition where a person experiences sudden SOB waking up from sleep, wake up gasping for air.
Associated with fluid build-up during lying down
Define a dry cough
A cough that does not produce phlegm or mucus, it is caused by allergens, irritants, infections, asthma or HF. It is not a productive cough as it does not clear the airways
Define haemoptysis
This refers to the coughing of sputum containing blood from lungs. it can indicate pulmonary infection, HF or lung cancer. It can have small to large streaks of blood. It requires immediate medical attention to determine underlying cause.
What can palpitations indicate?
Bradycardia, Tachycardia or ectopics
Define syncope and it’s indications
Loss of conciousness due to a drop in BP, it can be cardiac/non-cardiac related.
Cardiac: arrythmia, heart bloc, sinus arrest
Non-cardiac: POTS, vasovagal neurally mediated, orthostatic hypertension
Describe fatigue as a symptom of HD
Fatigue indicates low CO & exercise tolerance.
People with HF may feel excessive tiredness so are unable to carry out normal daily tasks. Fatigue may worsen during exertion as the heart has to work harder to meet demand for O2.
Fatigue in HF is not relieved by rest & is often persistent, despite taking breaks
What causes fatigue to appear as a symptom of HD
- Reduced CO due to heart’s inability to pump blood properly to perfuse all organs appropriately causing fatigue
- Fluid build-up, may accumulate in lungs or limbs, making it harder to breathe and exhaustion
- Reduced O2 supply, When coronary arteries are blocked less oxygenated blood reaches myocardium leading to fatigue
- Inefficient Blood Circulation: Any heart condition that impairs the heart’s ability to circulate blood effectively can cause a feeling of extreme tiredness and weakness.
