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Differential Dx > Cardiovascular Screening > Flashcards

Cardiovascular Screening Flashcards

1
Q

Cardinal Symptoms of Cardiac Disease

A
  • Chest, neck, arm pain
  • palpitation
  • dyspnea
  • syncope
  • fatigue
  • diaphoresis
  • cyanosis
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2
Q

Heart spinal segments

A

C3-T4

-can have referred to these somatic areas with heart issues

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3
Q

Patient describes a bump, pound, jump, flop, flutter, or racing heart

A

palpitation

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4
Q

If you have palpitation w/ family Hx of sudden death..

A

immediate medical referral

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5
Q

Reffered to as breathlessness or shortness of breath

A

dyspnea - can have cardiovascular origin

-often caused by left ventricle that is unable to fully contract

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6
Q

Shortness of breath and Paroxysmal Nocturnal Dyspnea suggest…

A

CHF

-if you can’t climb a flight of stairs without SOB then a referral is likely necessary

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7
Q

Arrhythmias, orthostatic hypotension, poor ventricular functioning, CAD, and vertebral artery issues all can cause…

A

Cardiac Syncope

-referral or further investigation is needed especially if it occurs w/o warning

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8
Q

What is a good way to monitor fatigue?

A

Vital signs

-often BP will not rise with increasing exercise if it is of cardiac origin

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9
Q

Edema in the form of a 3-pound or greater gain in ankles, abdomen, or hands combined w/ SOB, fatigue suggests…

A

Major red flag of progressive CHF

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10
Q

Most common CV conditions to mimic MS dysfunction are…

A

angina, MI, pericarditis, dissecting aortic aneurysm

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11
Q

Myalgia and myopathy may result from this medication…

A

Statins…

  • are used for LDL cholesterol
  • risk is highest for those w/ liver disease, acute infection, hypothyroidism
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12
Q

Involves hardening of the arteries and plaque buildup, ultimately leading to ischemia and necrosis

A

Atherosclerosis

-symptoms may not show until the lumen of coronary artery narrows by 75%

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13
Q

While 1 in 30 women deaths occur from breast cancer, 1 in 2.5 deaths occurs from…

A

Heart Disease

-symptoms are felt differently for women than men often described as breathing cold air, SOB, weakness, lethargy

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14
Q

Results from imbalance between cardiac workload and oxygen supply to myocardial tissue…

A

Angina.

  • Multiple types…chronic stable, resting, unstable, nocturnal, atypical, prinzmetal’s
  • most often seen as left shoulder pain, chest pain, neck, jaw, teeth pain
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15
Q

Squeezing, burning, pressing, choking, aching, bursting describes what type of pain….

A

Angina

  • often feels like gas or heartburn
  • should only last 1-3 minutes
  • rest or nitroglycerine (vasodilation) helps
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16
Q

Coronary occlusion leads to what is called…

A

MI

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17
Q

When is MI most common?

A

Morning. Its when the clotting system is active, BP surges, HR increases. Stress hormones are also increased in the morning
-also tends to occur when working with arms overhead

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18
Q

Sudden loss of responsiveness, no normal breathing, and no signs of circulation indicate…

A

Sudden Cardiac Arrest

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19
Q

Severe fatigue, chest or radiating pain, pallor, profuse sweating, nausea, vomiting suggest…

A

MI

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20
Q

May initially have no signs or symptoms. Progress to chest pain and dyspnea, increased HR, rise in temp, malaise, myalgia, pain worse w/ breathing or trunk movements

A

Pericarditis - inflammation of the pericardium

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21
Q

Described as the physiological state in which heart is unable to pump enough blood to meet metabolic needs…

A

CHF

-usually will see SOB, swelling, fatigue, weakness, cough, orthopnea, pulmonary edema, cerebral hypoxia, cramping

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22
Q

Failure of one ventricle in CHF is usually followed by failure of the other. This is called…

A

Ventricular Interdependence

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23
Q

A condition in which the left ventricle stiffens and hypertrophies, thus unable to fill completely leading to decreased output…

A

Diastolic Heart Failure

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24
Q

Results when vessel or heart wall becomes weakened from trauma, congenital conditions, infection, or atherosclerosis…

A

Aneurysm

  • can be thoracic or peripheral
  • HTN is a big risk factor
  • abdominal > thoracic
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25
Q

Marfan Syndrome, Loeys-Dietz Syndrome, Turner Syndrome, Vascular Ehlers-Danlos Syndrome all predispose patient to…

A

Aneurysm

-also any anterior orthopedic spinal procedures predispose as well

26
Q

Feeling of heartbeat in abdomen or back pain described as sharp, intense, severe, or knifelike…

A

Abdominal aortic aneurysm

  • risk of rupture approaches 25% for AAAs that are 6.0cm.
  • should palpate then auscultate for bruits
  • abdominal aorta passes by T12 then bifurcates
27
Q

Stenosis, Insufficiency, and Prolapse all describe issues of what cardiac structure…

A

Valves!!

-often these people are asymptomatic. Needs extensive auscultation to differentiate.

28
Q

Often is a child or young adult w/ recent cold or sore throat for 3 weeks and painful migration of symptoms to joints. Also fever, fatigue, malaise, weakness…

A

Rheumatic Fever

-can have a chronic effect on heart valves

29
Q

Bacterial endocarditis causes inflammation of the cardiac endothelium but may also cause…

A

Tricuspid, aortic, or mitral valve damage.

-may see MS arthralgias, 1/3 have LBP, and may present like herniated disk w/ radiculopathy

30
Q

Characterized by mitral leaflet thickness w/ increased extensibility, decreased stiffness, and decreased strength…

A

Mitral Valve Prolapse

  • likely congenital
  • asymptomatic in isolation. Symptoms usually due to imbalance in ANS called dysautonomia
31
Q

Profound fatigue not attributed to exercise or stress, cold hands and feet, SOB, chest pain, palpitations all suggest…

A

Mitral Valve Prolapse

32
Q

Clients who are neurologically unstable may be susceptible to…

A

cardiac arrhythmias

-these patients should have vitals measured carefully during exercise

33
Q

People with _____ are at greater risk of clot migration, especially if on blood thinners

A

A-Fib - can increase risk of stroke or heart failure

  • at risk if previous MI, high BP, CHF, pericarditis, rheumatic mitral stenosis, excessive thyroid hormone, excess alcohol or caffeine consumption, high fevers
  • S/S dizziness, chest pain, fainting
34
Q

_____ would suggest vessels cannot relax fully and remain somewhat constricted requiring the heart to work harder

A

HTN - is often in conjunction with PAD

  • major risk factor for cardiac disease
  • risk is varied with measurements but also risk factors including family Hx
35
Q

_____ describes elevated BP in doctor office

_____ describes lower BP in doctor office

A

White-coat HTN

Masked HTN

36
Q

Stress, diet, exercise, obesity all represent _____

A

modifiable risk factors of HTN

37
Q

TIA stands for ______

A

Transient Ischemic Attack

  • may last as long as 24 hrs to just minutes
  • are important warning signals that obstructions exist. they are predictors of stroke.
38
Q

_____ refers to intermittent episodes during which small arteries or arterioles in extremities constrict, causing temporary pallor and cyanosis of the digits and changes in skin temperature

A

Raynaud’s Syndrome

-is a vasospastic or vasomotor disorder

39
Q

Acute venous disorders are caused by the formation of what?

A

Thrombi or clots

  • this could be DVT in leg
  • caused by venous stasis, hypercoagulability (may accompany malignant neoplasms), or injury to venous wall
40
Q

Appear red, raised, warm, tender, maybe fever, chills, malaise, often in the LE

A

DVT
+ Homan’s sign (insensitive and nonspecific)
should get an ABI

41
Q

Identified by swollen limbs, thick and course brownish skin around ankles, and possible venous ulceration

A

Postphelbitic Syndrome - also known as chronic venous disorders - monitored for life

42
Q

Increased levels of potassium can cause _____

A

arrhythmias and asystole

43
Q

Sodium levels will typically drive ______

A

swelling or diuresis

-vomiting, diarrhea, or excessive diaphoresis can cause this to decrease

44
Q

A decrease in _____ results in myocardial irritability and cardiac arrhythmias

A

Magnesium

45
Q

NSAIDs have the ability to negate the ________ of ACE inhibitors

A

antihypertensive effects

46
Q

Diuretics help lower BP but have SE of ______

A

muscle weakness, spasms, dizziness, headache, incoordination, and nausea

47
Q

These drugs work to relax the blood vessels and heart muscle by binding to ______ on the SA node and myocardial cells, lowering force of contraction and HR

A

Beta-Blockers

beta receptors

48
Q

Fainting w/o warning

A

Cardiac Red Flag

49
Q

cannot climb single flight of stairs w/o being severely winded

A

Cardiac Red Flag

50
Q

Palpitation with a history of unexplained sudden death in family

A

Cardiac Red Flag

51
Q

Neurologically unstable patients

A

Cardiac Red Flag

-possible for arrhythmias

52
Q

Nitroglycerin does not relieve angina pain

A

Cardiac Red Flag

53
Q

Abnormally severe chest pain w/ nausea and vomiting

A

Cardiac Red Flag

54
Q

Radiating angina pain and angina pain that is not relieved by rest

A

Cardiac Red Flag

55
Q

anyone w/ coronary stent experiencing chest pain

A

Cardiac Red Flag

56
Q

difference of more than 40 mmHg in pulse pressure

A

Cardiac Red Flag

57
Q

Women w/ chest or breast pain who have a positive family Hx

A

Cardiac Red Flag

58
Q

Anyone w/ trigger points should also be evaluated for _____

A

Trigger points

59
Q

Upper quadrant pain that can be reproduced by lower quadrant activity suggests ______

A

cardiac origin

60
Q

Back pain which looks like herniated disk but no neuro S/S suggests ______

A

Endocarditis

61
Q

3 P’s
Pleuritic Pain
Pain on Palpation
Pain with changes in Position

A

if there are 2/3 of these present, an MI is very unlikely

Differential Dx (12 decks)

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