CARDIOVASCULAR SYMPTOMS



CARDIOVASCULAR SYMPTOMS

Cardiovascular symptoms

Chest pain

Dyspnea

Paroxysmal nocturnal dyspnea PND

Orthopnea

Dyspnea on exertion DOE

Palpitations

Syncope

Peripheral edema

Claudication

CHEST PAIN

Chest pain or discomfort frequently raises concern about the heart diseases, but it commonly originates in other structures as well

The myocardium

The pericardium

The Aorta

The trachea and large bronchi

The parietal pleura

The esophagus

The chest wall

The extrathoracic structure

Myocardial infarction, angina pectoris

Pericarditis

Dissecting aneurysm

Tracheobronchitis

Pleurisy, Pericarditis

Reflux esophagitis, esophageal spasm

Costochondritis, herpes zoster

Cervical arthritis, biliary colic, gastritis

Questions to be asked from the patients

Do you have discomfort or unpleasant feelings in your chest?

Ask the patient to show the exact location and watch for any gestures

All seven attributes of the symptom are often needed to differentiate among the various causes of chest pain

It is important to ask “is the pain related to exertion?” Does it radiate to the neck, shoulder, back, or down the arm?”

Chest pain

Myocardial infarction

Angina pectoris

Pericarditis

Pneumonia

Pulmonary embolism

Pneumothorax

Pleuritis

Pleural effusion

Bronchogenic carcinoma

Musculoskeletal pain

Shortness of Breath

Dyspnea

Dyspnea is a nonpainful but uncomfortable awareness of breathing that is inappropriate to the circumstances

Dyspnea commonly results from the respiratory or cardiac disease, but also frequently accompanies anxiety

Questions to be asked from the patients

Ask if the patient has had any difficulty in breathing

Ask when the symptom occurs, at rest or with exercise, and how much effort produces it

Try to determine the severity based on the patient’s daily activities

How may steps or flight of stairs can the patient climb without pausing for breath?

How about work? Carrying the groceries?

Moping the floor or making the bed?

Carefully determine the timing and setting of dyspnea, associated symptoms, and factors that aggravate it or relieve it

Shortness of Breath (dyspnea)

difficulty in breathing

Bronchial Asthma

Chronic Bronchitis

Emphysema

Pneumonia

Left sided heart failure

Interstitial lung disease

Acute Pulmonary embolism

Spontaneous Pneumothorax

Anxiety with hyperventilation

PALPITATIONS

Palpitations are an unpleasant awareness of the heart beat

Skipping, racing, fluttering, pounding , or stopping of the heart

Transient skips suggest Premature contractions

Persistent irregularity suggest atrial fibrillation

Rapid regular beating suggest SVT

Questions to be asked

Are you sometimes aware of your heart beat?

What is it like?

Ask the patient to tap out the rhythm with a hand or finger

Was it fast or slow? Regular or irregular?

How long did it last? If there was an episode of rapid heart action, did it start and stop suddenly or gradually?

Paroxysmal Nocturnal Dyspnea

Episode of sudden dyspnea and orthopnea that waken the patient from sleep, usually 1 or 2 hours after going to bed

The patient typically sits up, stands up, or goes to a window for air

wheezing and coughing may be associated

the episode subsides spontaneously but may recur at about the same time on subsequent night

ORTHOPNEA

Dyspnea that occurs when the patient is lying down and improves upon sitting up

Classically quatified according to the numbers of pillows on which the patient sleeps or the fact that the patient prefers to sleep sitting up

It suggest Left ventricular failure, but may also accompany obstructive lung diseases

Syncope

Syncope is the sudden but temporary loss of conciousness that occurs when blood flow to the brain becomes insufficient

commonly described as fainting

The symptoms of impending faint, including muscular weakness, lightheadedness, and other premonitory feelings without actual loss of conciouness, are called near syncope or presyncope

Must be differentiated from the generalized seizures

Questions to be asked from the patients

Have you ever fainted or passed out?

Try to determine what seems to have precipitated the attack(s) and what kind of warning, if any, the patient felt before passing out

Was the patient sitting, standing, or lying down when the attack started?

How long did the episode last?

Did the patient blackout completely, or could voices be heard throughout the episode (indicating some consciousness)?

Could voices be heard while passing out and coming to?

Did anyone observe the episode?

If so, what did the patient look like before losing conciousness, during the episode, and afterwards?

How did the patient feel after recovery?

Syncope

Vasodepressor syncope (the common faint)

Postural hypotension

Cough syncope

Micturition

Cardiovascular disorders

arrythmias

aortic stenosis and hypertrophic cardiomyopathy

myocardial infarction

massive pulmonary embolism

Disorders resembling syncope

Hypocapnia

Hypoglycemia

Hysterical fainting due to a conversion reaction

EDEMA

It is the accumulation of fluid in the interstitial spaces, and appear as swelling

Can be generalized or localized

Pitting and non-pitting type

Questions to be asked

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download