Cardiovascular Signs and Symptoms Flashcards

1
Q

What would your differential be for chest pain which is increasing in severity over minutes or hours?

A
  • Angina or ACS
  • Oesophagitis/Oesophageal spasm
  • PE
  • Pneumothorax
  • Aortic dissection
  • Chest wall pain
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2
Q

What would your differential diagnosis for acute chest pain be (think of everything you would want to consider)?

A
  • ACS
  • Aortic Dissection
  • Pericarditis/Tamponade
  • Myocarditis
  • Arrhythmias
  • PE
  • Pneumonia
  • Pneumothorax
  • Pleurisy
  • Musculoskeletal
  • Chostochondritis
  • GORD
  • Anxiety
  • Oesophageal spasm
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3
Q

What are more chronic causes of chest pain?

A
  • Stable angina
  • PHT
  • Aortic Stenosis
  • Lung Cancer
  • Peptic Ulceration
  • Fibromyalgia
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4
Q

What would your differential diagnosis for lower chest or upper abdominal pain be?

A
  • GORD
  • Biliary colic
  • Pancreatitis
  • Peptic ulceration
  • Acute cholecystitis
  • MI
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5
Q

What would be the cause of sudden breathlessness with an onset over seconds?

A
  • PE
  • Pneumothorax
  • Anaphylaxis
  • Foreign body inhalation
  • Cardiac arrhythmia
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6
Q

What would your differential diagnosis be for acute breathlessness onset over minutes to hours?

A
  • Asthma exacerbation
  • COPD exacerbation
  • Acute LVF
  • ACS
  • PE
  • Acute bacterial/viral infection
  • All causes of sudden acute breathlessness - Pneumothorax, Anaphylaxis, Arrhythmia, foreign body, PE
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7
Q

What are causes of orthopnoea or PND?

A
  • Pulmonary oedema
  • COPD
  • Asthma
  • Cardiac arrhythmia
  • GORD - airway irritation on lying down
  • Respiratory muscle weakness
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8
Q

What are causes of palpitations?

A
  • SVT
  • Episodic heart block
  • Sinus Tachycardia
  • AF
  • Ventricular ectopics
  • Menopause
  • Thyrotoxicosis
  • Phaeochromocytoma
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9
Q

What would your differential for cough with pink frothy sputum be?

A
  • Acute pulmonary oedema due to LVF
  • Mitral stenosis
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10
Q

What would your differential for syncope be?

A
  • Vasovagal attack
  • Postural hypotension
  • Cardiac Arrhythmias
  • Aortic Stenosis
  • Hypertrophic cardiomyopathy
  • Micturition syncope
  • Cough syncope
  • CArotid sinus syncope
  • Hypoglycaemia
  • Epilepsy
  • TIA/Stroke
  • Massive PE
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11
Q

What would your differential for leg pain on walking be?

A
  • Arterial disease of the legs
  • Spinal claudication
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12
Q

What would your differential for leg pain on standing which is relieved by lying down?

A
  • Peripheral venous disease
  • Varicose veins
  • Disc protrusion
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13
Q

What would your differential diagnosis for unilateral leg swelling be?

A
  • DVT
  • Ruptured baker’s cyst
  • Cellulitis
  • Abnormal lymphatic drainage
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14
Q

What can cause bilateral ankle swelling?

A
  • RHF - due to PHT, CCF, Cor pulmonale
  • Abdominal mass - preventing venous return
  • Hypoalbuminaemia
  • Bilateral cellulitis - in those with DM
  • Drugs - CCBs or alpha blockers
  • Bilateral thrombosis
  • Impaired lymphatic drainage - lymphangitis, abnormal drainage
  • Immobility
  • Congenital oedema
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15
Q

What are causes of peripheral cyanosis?

A
  • Raynaud’s
  • Arterial obstruction - atheroma or small vessel disease
  • Haemorrhage
  • Low cardiac output - HF
  • Septicaemia - gram -ve organisms commonly
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16
Q

What are causes of central cyanosis?

A
  • R->L cardiac shunt - cyanotic heart disease
  • R->L pulmonary shunt due to atelactesis or consolidation
  • Haemoglobin abnormalities
  • Asthma exacerbation
  • Severe pulmonary fibrosis
  • Neuromuscular disease
  • PHT
  • PE
17
Q

What are pathological causes of tachycardia?

A
  • Fever
  • Haemorrhage
  • Hypoxia
  • Thyrotoxicosis
  • Severe anaemia
  • HF
  • PE
  • Drugs
  • Cardiac tachyarrhythmias, SVT, AF, VT
18
Q

What are pathological causes of bradycardia?

A
  • Drugs
  • Sinoatrial disease
  • MI
  • Hypothyroid
  • Hypothermia
  • Severe electrolyte disturbance
19
Q

What are causes of an irrgeular pulse?

A
  • AF
  • Atrial flutter
  • Atrial/ventricular ectopics
  • Wenkebach
  • VF
20
Q

What are causes of a high pulse volume?

A

Aortic incompetence

21
Q

What are causes of a low volume pulse?

A
  • IHD
  • Cardiomyopathy
  • Cardiac Tamponade
  • Constrictive pericarditis
  • Hypovolaemia
  • Vasodilation - typically septic
  • Aortic Stenosis
22
Q

What are causes of hypertension?

A
  • Temporary
  • Essential - 95% cases
  • Pre-eclampsia/eclampsia
  • Obstructive sleep apnoea
  • Renovascular disease
  • Primary renal disease
  • Co-arctation
  • Conn’s syndrome/primary hyperaldosteronism
  • Cushing’s
  • Acromegaly
  • Phaeochromocytoma
  • Drug-induced - NSAIDs, Oestrogen, Steroids
23
Q

What are causes of a postural fall in BP?

A
  • Drug induced
  • Autonomic neuropathy
  • Idiopathic
  • Low ouput heart conditions
  • Low BV - haemorrhage, dehydration
  • Septicaemia
  • Adrenal failure
  • MS
  • Parkinson’s disease
24
Q

What can cause a different BP/pulse between arms?

A
  • Thrombosis/Dissection
  • Supravalvular aortic stenosis
  • Subclavian steal syndrome
  • Thoracic inlet syndrome
25
Q

What can cause prominent leg veins?

A
  • Varicose veins
  • Thrombophlebitis
  • DVT
26
Q

What are causes of a raised JVP?

A

PQRST plus arrythmias

  • Pericardial effusion/contrictive Pericarditis
  • Quantity - volume overload
  • Right heart failure - CCF, cor pulmonale
  • Superior vena cava obstruction (SVC syndrome)
  • Tricuspid regurgitation (V waves)/Tricuspid stenosis
  • Complete heart block
  • AF
27
Q

What are causes of extra heart sounds?

A
  • Normal young heart
  • Heart failure
  • Cardiomyopathy
  • Constrictive pericarditis
  • Severe HF
28
Q

What are the causes of a mid systolic/ejection systolic murmur (anywhere on the chest)?

A
  • Aortic stenosis
  • Hypertrophic cardiomyopathy
  • Aortic Sclerosis
  • ASD
  • Pulmonary stenosis
29
Q

What are causes of a pansystolic murmur?

A
  • Mitral incompetence
  • Tricuspid incompetence
  • VSD
30
Q

Where would you hear the murmur of mitral stenosis?

A