Understanding Symptoms And Signs Flashcards
What is ischaemic muscle pain
• When muscle is ischaemic the pH drops and this is thought to be a key factor in stimulating pain afferents
(nociceptors) in muscle. Substance P, a neuropeptide is released locally which then increases the sensitvity of
pain afferents in muscle
• Ischaemia means insufficient blood supply to a cell, tissue or organ. It is the lack of oxygen that is particularly damaging
What are words used to describe the pain from ischaemic muscle pain
• Tight • Vice-like • Constriction • Heavy • Crushing • Cramping • Pressing • Tearing • Pressure • Choking feeling in throat (cardiac)
estures often used to describe the p
What are someme gestures used to describe the pain
See slide
What are the cardiac symptoms of cardiac muscle ischaemia
Cardiac muscle ischaemia
• Angina • Unstable Angina • Myocardial infarction
What can bring on angina
• Cardiac pain brought on by exercise, stress, emotion,
cold weather or a meal. Explain why? • Pain resolves with rest. Explain why? • Pain relieved by GTN. Why?
Heavy meal - bld supply to gut increased, heart does more work - tissues ischaemic in heart
What is unstable angina
• Angina that occurs at rest, more intense than stable angina, may last longer, does not respond to GTN. ECG
may show ST depression or T wave inversion but no ST elevation. Cardiac markers are not raised
• Unstable angina may be theprecursor to myocardial infarction
Describe the presentation of mi
Often spontaneous onset of cardiac pain that does
not go away with rest, nitrates and is usually worse
than angina pain. Often the patient is sweaty, nauseated, dyspnoeic, pale, clammy and fearful for
their life. Why?
What are the cardiac symptoms
• Palpitations - a noticeably rapid, strong, or irregular heartbeat due to agitation, exertion, or illness
– Ask about the timings of such events. Exercise or emotion related? Only at night? Random? Caffeine? Smoking? Alcohol? Drugs?
– How long do they last?
– Associated with dizzyness or light headedness?
– Ever been associated with collapse/loss of consciousness?
– Ask the patient to “tap the heartbeat out on a table”
What are the causes of palpitations
- Heightened awareness of normal heart beat
- Sinus tachycardia
- Atrial or ventricular ectopic beats
- Atrial tachycardias (SVT, fibrillation, flutter)
- Ventricular tachycardia/fibrillation
What is Orthoptera
Orthopnea or orthopnoea is shortness of breath (dyspnea) that occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair.
What is one?
Paroxysmal nocturnal dyspnea or paroxysmal nocturnal dyspnoea (PND) refers to attacks of severe shortness of breath and coughing that generally occur at night. It usually awakens the person from sleep, and may be quite frightening.
Why does one occur at night and why is it relieved by sitting up?
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When can collapse/loc occur?
This can occur in no/low output cardiac tach or brady
arrhythmias. The cause of the collapse/loss of
consciousness is cerebral hypoperfusion
What needs to be assessed in cvs examination
Rate, rhythm, character/quality
What is the normal range of pulse rate?
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