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2b > Cardiac history > Flashcards

Cardiac history Flashcards

1
Q

Order of the history

A 
Presenting complaints
History of PC
Past medical history
DH and allergies
Family history
Social history and smoking
SE and risk factors
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2
Q

Main cardiac symptoms

A 
Chest pain
Breathlessness
Palpitation
Syncope or presyncope
Fluid retention
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3
Q

How to investigate chest pain

A

SOCRATES

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4
Q

Types of cardiac chest pain

A

Ischaemic and non ischaemic

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5
Q

Causes of ischaemic chest pain

A

Angina pectoris and ACS

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6
Q

Causes of non ischaemic chest pain

A

Pericarditis, myocarditis, aortic dissection and others

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7
Q

Causes of gastro oesophageal non cardiac chest pain

A

GORD/Spasm and peptic ulcer

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8
Q

Causes of non gastro oesophageal non cardiac pain

A

Pulmonary, musculoskeletal and psychosomatic

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9
Q

Factors pointing towards ischaemic cardiac pain

A 
Character of pain
Location of pain
Provoking factors
Relieving factors
Associated symptoms
Associated risk factors
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10
Q

Cardiac causes of breathlessness

A

IHD, LVF, valves

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11
Q

Pulmonary causes of breathlessness

A

Airway disease, PE, Others

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12
Q

Questions for breathlessness

A 
When did it start?
How quickly did it come on?
Circumstances?
Relieving or exacerbating factors?
Associated features?
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13
Q

Circumstances of breathlessness

A

Exertional
Postural, orthopnoea
Nocturnal. paroxysmal nocturnal dyspnoea

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14
Q

Relieving factors for breathlessness

A

Position
Rest
Oxygen, nebulisers or other medication

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15
Q

Features associated with breathlessness

A

Wheeze, cough, fever, pain

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16
Q

Define orthopnoea

A

Shortness of breath on lying flat that is relieved by sitting upright

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17
Q

Define paroxysmal nocturnal dyspnoea

A

Acute dyspnoea that wakes the patient from sleep

18
Q

Cardiac causes of fluid retention

A

Congestive heart failure
Right heart fialure
Pericardial

19
Q

Protein loss causes of fluid retention

A

Hepatic
Renal
GI

20
Q

Questions for fluid retention

A

Onset and duration

Location

21
Q

Peripheral oedema specific considerations

A 
Unilateral/bilateral
Onset
PMH
Medications
Associated symptoms
22
Q

Peripheral oedema PMH of significance

A

Malignancy, heart and lung disease, diabetes

23
Q

Peripheral oedema drug history of significance

A

Dihydropyridine calcium channel blockers

24
Q

Peripheral oedema associated symptoms

A

Pain and SOB

25
Q

Causes of palpitations

A 
Cardiac arrythmias
Structural heart diseases
Psychosomatic disorders
Systemic causes
Drugs: medical, recreational
26
Q

Palpitation questions

A 
Onset and duration
Nature 
-what does it feel like
-tap out rhythm
-regular or erratic
Relieving or exacerbating factors
Associated symptoms
27
Q

Palpitation associated symptoms

A 
Nausea and vomitting
Sweaty or clammy
Short of breath
Light headed
Loss of consciousness
28
Q

Palpitation special considerations

A 
Age of patient
Onset
Duration
Frequency and timing
Associated activity
Diet
Drugs
29
Q

Define syncope

A

Sudden and brief loss of consciousness associated with a deficit of postural tone, from which recovery is spontaneous

30
Q

Define presyncope

A

The feeling of imminent loss of consciousness but not progressing to loss of consciousness

31
Q

Cardiovascular causes of syncope

A 
Hypovolaemia
Postural hypotension
Cardioneurogenic syncope
Carotid sinus hypersensitivity
Arrythmias
Aortic stenosis, LVOT obstruction
32
Q

What is cardioneurogenic syncope

A

Faint

  • vasodepressor
  • cardiodepressor
33
Q

Neurological causes of syncope

A

Epilepsy

CVA (not often)

34
Q

Other causes of syncope

A

Metabolic

Drugs

35
Q

Questions for syncope

A

Onset and duration
Nature
Associated features
Witnesses

36
Q

Associated features of syncope

A 
Sick
Sweaty or clammy
Chest pain
Incontinence
Injuries
Memory of the event
37
Q

Cardiac PMH

A

Cardiac history
Cardiovascular risk factors
Cardiac procedures

38
Q

IHD risk factor assessment

A 
Age
Smoking
Hypertension
Dyslipidaemia
DM
Family history of IHD
Physical inactivity and obesity
Vascular disease
39
Q

Drug history

A

Cardiac medication
Other medication
Allergies
Interactions

40
Q

Family history

A

Ischaemic heart disease
Sudden cardiac death
Risk factors

41
Q

Social history

A

Smoking- IHD
Drinking- arrhythmias, cardiomyopathy
Occupation

42
Q

Breathless lying down, relieved by sitting up

A

Orthopnoea

2b (28 decks)

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