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MD3001 > W01L01 History Taking: The Cardiovascular System > Flashcards

W01L01 History Taking: The Cardiovascular System Flashcards

1
Q

Cardiovascular system enquiry

A 
Chest Pain
Palpitation
Dyspnoea (SOB)
Syncope (LOC)
Dizziness
Oedema
Fatigue
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2
Q

Peripheral venous insufficiency symptoms

A 
Ulcers
Venous eczema
Varicose veins
Oedema
Discolouration
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3
Q

Peripheral arterial insufficiency symptoms

A

Hair loss
Necrotic areas
6 P (pain, pallor, perishing cold, pulselessness, paresthesia, paralysis)
Could be caused by emboli

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4
Q

People with peripheral arterial disease likely to also have…

A

Cerebrovascular and coronary artery diseases

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5
Q

Intermittent claudicaiton

A

calf pain due to inadequate blood supply

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6
Q

Claudication distance

A

the distance you can walk before you get calf pain

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7
Q

Acute limb ischaemic

A

5P (pain, pallor, perishing cold, paraesthesia, paralysis)

Commonly caused by embolic disease

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8
Q

Critical limb ischaemia

A

Blood supply is so narrowed, the patient develops minimal symptoms
In very severe cases, the pain comes on during rest

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9
Q

Clarifying symptoms

A 
Speed of onset
Duration/frequency
Severity/character
Radiation
Associated symptoms
Aggravating/relieving factors
Impact on quality of life
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10
Q

Past medical history (points to consider)

A 
History of vascular disease
Diabetes
Hyperthyroidism
Renal disease (eGFR, urea, creatinine)
Hypertension
Hypercholesterolaemia
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11
Q

Angina

A

A clinical syndrome of chest pain or pressure precipitated by activities such as exercise or emotional stress which increase myocardial oxygen demand

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12
Q

Angina key symptom

A

Central chest tightness - not necessarily pain, but discomfort or heaviness

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13
Q

Stable angina episodic central

A

tight/heavy/retrosternal or left side of chest/crushing/band-like

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14
Q

Stable angina radiation

A

to jaw, neck, back, one or both arms

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15
Q

Stable angina associated symptoms

A

sweating, nausea, breathlessness

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16
Q

Stable angina aggravating and relieving factors

A

aggravated by exertion, cold, emotion

ALWAYS relieved by rest and GTN (Nitroglycerin) spray

17
Q

Is stable angina predictable?

A

Yes, similar to intermittent claudication
Appears with exercise and goes away with rest/GTN spray
Different from unstable angina

18
Q

Key features of stable angina

A

Predictable in onset
Reproducible
Relieved by rest or GTN
Stable angina is NOT an acute coronary syndrome

19
Q

Acute myocardial infarction

A

Sustained chest pain not relieved by GTN
ECG changes and cardiac enzyme release
Silent MI in diabetics and elderly

20
Q

Acute coronary syndromes

A

Unstable Angina
Non St elevation myocardial infarction (NSTEMI)
ST elevation myocardial infarction (STEMI)

21
Q

Unstable Angina

A

On minimal exertion or rest
Worsening in intensity, frequency, duration
ECG may be normal
Clinically difficult to distinguish from acute MI

22
Q

NSTEMI (non ST elevation myocardial infarction)

A

Symptoms suggest acute MI
ECG may be normal or non-specific abnormalities such as ST segment depression or T wave inversion
Blood test will show troponin release and usually elevated cardiac enzymes such as creatine kinase or lactate dehydrogenase

23
Q

STMI (ST elevation myocardial infarction

A

Symptoms suggest acute MI
ECG show acute ST segment elevation and Q waves likely to develop to represent the full thickness of the myocardium being damaged
Blood test will show troponin release and elevated cardiac enzymes
Early effective treatment may limit myocardial damage

24
Q

Only difference between NSTEMI and STEMI

A

ECG

25
Q

Pericarditis

A

Inflammation of pericardium

Relieved by sitting forwards

26
Q

Aortic dissection

A

Sudden and severe tearing and deep pain
Radiates to left shoulder/back
Surgical emergency

27
Q

Non modifiable cardiovascular risk factors

A 
Age
Ethnicity
Sex
Personal/Family history
Low birth weight
28
Q

Modifiable cardiovascular risk factors

A 
Hypertension
Hyperlipidaemia
Diabetes
Obesity
Smoking
Sedentary lifestyle
29
Q

Dysponea

A

Shortness of birth

30
Q

Orthopnoea

A

Shortness of breath when lying flay

31
Q

Paroxysmal nocturnal dyspnoea

A

Waking up in the middle of the night with shortness of breath
When lying down, venous return is increased and if the heart has trouble clearing the fluid, pressure builds up in the lungs and fluid leaks into the lungs space (pulmonary oedema), causing chest pain

32
Q

Dyspnoea - causes

A

Cardiac failure or angina or MI

Respiratory

33
Q

Palputation

A

Awareness of heartbeat

Causes could be premature beats (ectopics), tachy or bradycardia

34
Q

Dizziness

A

Lightheadedness vs vertigo

35
Q

Syncope

A

Sudden/brief loss of consciousness

36
Q

Red Flags

A 
Chest pain
Palpitation
Dyspnoea
Syncope
Dizziness
Oedema
Fatigue

MD3001 (13 decks)

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