symptoms and signs of cvd Flashcards
cardiovascular symptoms include:
Chest pain
Dyspnoea ( – of breath)
Peripheral Oedema ( — )
Palpitations (an awareness of your — )
Dizziness
Syncope ( — )
shortness
swelling
heartbeat
fainting
chest pain:
Common symptom among a range of cardiac conditions
Underlying cause is usually – to heart muscle
Myocardial infarction due to a – in a — supplying the heart muscle, which leads to – and eventually —
Arrhythmia causing the heart to beat very – leads to insufficient — supply to heart muscle to meet demand, resulting in —
Other causes of chest pain can include— , such as in myocarditis or pericarditis
Chest pain which has features suggestive of being cardiac in origin based on clinical history
These features include (but are not limited to):
Pain centrally located in the chest
Pressure or crushing type character
Radiating to the arm/neck/jaw
Exacerbated by exertion
Alleviated by rest and/or nitrates
ischemia
blockage
coronary artery
ishcemia
necrosis
fast
oxygen supply
ischameia
direct inflammation
Dyspnoea (also called — of breath) typically occurs in cardiac conditions where there is a — in the output of the — (e.g. congestive cardiac failure)
This has two effects which lead to dyspnoea
1- Due to — peripheral tissue — with blood, the body tries to compensate by — the respiratory rate in order to — oxygen saturation of blood so that more oxygen is getting to peripheries
2- With reduced — output, there is an — in the — pressure of the blood in the pulmonary capillary beds, leading to extravasation of fluid into the interstitium, which leads to pulmonary oedema
-Exertional shortness of breath
-Orthopnoea
-Paroxysmal Nocturnal Dysponea
shrotness
decreased left ventricle
decreased
perfusion
increasing
increased
left vencicular output
increase
hydrostatic
-Peripheral oedema is a common complaint among patients with —
-It primarily occurs first in the — (due to the effect of – ), extending proximally up the — limb, depending on how fluid overloaded the patient is
-Patients can also develop sacral oedema if they are lying — in bed for extended periods of time
-This oedema is ’pitting’ in nature, i.e. when the oedematous tissue is pressed into with a finger, that area of tissue will retain a depressed pit for a period of time afterwards
It occurs via a similar mechanism to pulmonary oedema, however is due to decreased —- output (as opposed to — output in pulmonary oedema)
cardiac failure
foot/ankle
gravity
lower
supine
right venticualr
left ventricular
-Palpitations refer to an — awareness of ones own —
-Can be referred to by patients as a — or – sensation in the chest
-They can occur due to benign causes, however can signify more — in the heart
-Examples of causes of palpitations include:
Congenital abnormalities of cardiac conduction pathways (e.g. Wolf-Parkinson-White Syndrome)
- – -induced (e.g. cocaine)
- —(e.g. thyrotoxicosis)
- — abnormalities in cardiac in ion channels (e.g. Brugada syndrome)
- Psychosomatic causes (e.g. anxiety)
-Ischaemia (e.g. myocardial infarction)
abnormal
heartbeat
fluttering or pounding
serious arrhythmias
drug
endocrine
genetic
Dizziness is caused by diminished — flow — to — cardiac output
This can be caused by the following:
- — abnormalities e.g. — of the aortic valve
- Failure of the — action of the heart e.g. Congestive Cardiac Failure
- — e.g. third degree heart block
cerebral blood flow
2ndary
decreased
structural
stenosis
pumping
arthemias
Syncope is a transient loss of — , usually accompanied by loss of — (resulting in collapse to the ground, with poor or no recollection of the event)
Characterised by:
— onset
— duration
— complete recovery.
The same underlying cardiac pathologies that cause dizziness can also cause syncope
consciousness
postural tone
rapid
short
spontaneous
cardiovascular signs:
Clubbing
Raised Jugular Venous Pressure (JVP)
Peripheral Oedema
Displaced Apex Beat
Thrill
Parasternal Heave
Murmur
Clubbing refers to bulbous — of the — of the fingers or toes
Graded 1 - 5 according to severity
Grade 1 – — / — of nail bed
Grade 2 – 000 of the nail-bed angle
Grade 3 – Increased — of the nail
Grade 4 - Fingertip develops a – ( — ) appearance
Grade 5 – – oesteoarthropathy
Occurs as a sign in a wide range of conditions
Cardiac causes of clubbing include:
— congenital heart disease
Atrial –
Infective –
enlargement
end
fluctuation/sufotening
loss
curvatation
clubbed ( drumstick )
hypertrophic
cyanotic
myxoma
endocarditis
raised jugular venous pressure:
Jugular Venous Pressure (JVP) is a means of – the pressure within the — system by — the — of the column of blood within the —
As the internal jugular vein commutes to the— without any intervening valves, the JVP provides information on the function of the — and —
A raised JVP is caused by increased — pressure, which is transmitted back to caused increased — within the —
observing
venous
visualising
height
internal jugular vein
right atrium
right atrium and right ventricles
right ventricular pressure
venous pressure
internal jugular vein
- peripheral oedema:
Accumulation of — within tissue
Pitting in nature
Associated with — sided heart failure - displaced apex beat:
The apex beat is the most — ,— point at which the palpating fingers are raised with each—
-Its normal position is in the — intercostal space midclavicular line
-Causes of displaced apex beat include:
Left ventricular dilatation
Right ventricular dilatation
Cardiomegaly
Chest wall deformities
Mediastinal mass
Tension pneumothorax
fluid
right
most lateral
inferior
systole
fifth intercostal
parasternal heave:
Parasternal heave is an impulse which is – when the heel of the hand is rested just to the — of the —
This is present in — enlargement/hypertrophy
palpale left
sterum
right ventricular
A murmur is an — sound heard on auscultation of the heart, which is caused by —
This turbulence can be created as blood flows across a structurally abnormal — , or through a defect in the —
-Such as an abnormally narrow valve (—)
-Or a valve that is — , for example,in aortic regurgitation an incompetent aortic valve is allowing blood to flow back into the left ventricle
-In young/thin people, can also get a so-called — (also known as a – murmur or an ‘—’ murmur), where there is no underlying structural abnormality in the heart
additional sound
turbulent flow
heart valve or heart septum
aortic stenosis
leaking
fucntional
physiologic/innocent
When a murmur is appreciated, the following should be considered to help determine its cause:
— in relation to the cardiac cycle (systolic v.s diastolic murmurs)
— of — intensity
— (how loud the murmur is)
1/6: very soft
2/6: soft
3/6: moderate [no thrill]
4/6: loud, palpable thrill
5/6: very loud, thrill easily palpable
6/6: very, very loud (audible without stethoscope)
— (does the sound of the murmur travel anywhere else?)
Effect of —
timing
area
greatest
grade
radiation
dynamic manoveres
A thrill is a —– a — sensation that can be felt when palpating over the —
If a murmur has an associated thrill, it is by definition a — or —
Assessed by placing the fingertips over the heart valves (at the same points on the precordium where heart sounds are auscultated)
palpable murmur
vibration
precordium
grade 4 or higher
congestive cardiac failure symptoms and signs:
pericaditis symtoms and signs:
1- symptoms:
Dyspnoea
Particularly dyspnoea on exertion
Chest pain
Fatigue
Peripheral oedema
2- signs:
Tachypnoea
Weak pulse
Pitting peripheral oedema
Raised JVP
Added S3 on auscultation
3- symptoms:
Chest Pain
Central/anterior, sharp, usually non-radiating, exacerbated by lying down, alleviated by leaning forward
Dyspnoea
May have a viral illness prodrome
Fever, malaise, myalgia
4- signs:
Diaphoresis
Pulsus paradoxus
Paradoxical drop in BP of >10mmHg on inspiration
Kussmaul’s sign
Paradoxical rise in JVP on inspiration
Pericardial friction rub
High pitch scratchy sound heard on auscultation of the heart
acute coronery syndrome:
symptoms :
Chest pain
Central, crushing, radiating to the neck/jaw/arms, exacerbated by exertion
Dyspnoea
Dizziness
Nausea/Vomiting
signs:
Diaphoresis
Tachypnea
Raised JVP
Can occur due to right sided heart failure in acute myocardial infarction
Heave
Murmur
Can occur due to papillary muscle rupture secondary to ischaemia
arthythimas symtoms and signs:
myocarditis:
symptoms:
Chest pain
Central, acute onset, usually no radiation, intermittent
Palpitations
Dizziness
Syncope
signs;
Drowsy
Weak pulse
Tachycardia
Raised JVP
Murmur
Can occur due to valvular dysfunction
symtoms:
Chest pain
Central, tight character, may radiate to the arm/shoulder/jaw, constant
May have a viral illness prodrome
Fever, malaise, myalgia
Dyspnoea
Palpitations
signs:
Raised JVP
Auscultation
Soft S1
Added S3
Pericardial friction rub
