Classic Presentations - Cardiovascular

Question 1

Tight chest pain on exertion or emotional stress, radiating to the jaw and/or arms that is relieved by rest

Answer 1

Stable angina

Question 2

A patient with a diagnosis of angina experiences angina-like pain at rest which GTN is not effective at relieving

Answer 2

Unstable angina

Question 3

A patient with a history of hypertension experiences new onset, severe chest pain that radiates to arm/jaw

Answer 3

MI

Question 4

A patient with a history of ischemic heart disease has exertional dyspnoea, paroxysmal nocturnal dyspnoea, orthopnoea, raised JVP, ankle oedema and late, high-pitched inspiratory and expiratory crackles at the base of the lungs

Answer 4

Congestive heart failure

Question 5

A patient with a history of IHD has been experiencing breathlessness, fatigue and ankle swelling.

On auscultation, they are found to have a pansystolic murmur, heard best at the apex with the diaphragm of the stethoscope when the patient is in the left lateral decubitus position

Answer 5

Mitral regurgitation

Question 6

An older patient has been experiencing breathlessness, dizziness and chest pain.

On auscultation they are found to have an ejection systolic murmur that radiates to the carotids

Answer 6

Aortic stenosis

Question 7

A patient with a history of childhood rheumatic fever is experiencing breathlessness on exertion, fatigue, palpitations and malar flush.

On auscultation they are found to have mid-diastolic rumbling

Answer 7

Mitral stenosis

Question 8

A patient with a history of connective tissue disorders and ulcerative colitis experiences breathlessness, chest pain and dizziness.

On examination they have a collapsing pulse, a displaced apex and an early diastolic murmur can be heard

Answer 8

Aortic regurgitation

Question 9

A PWID with bad teeth presents with breathlessness, fever, fatigue and weight loss

Answer 9

Infective endocarditis

Question 10

A patient with a history of IHD reports pain in their legs while walking. On examination, their legs are pale and hairless

Answer 10

Intermittent claudication

Question 11

A patient with a history of IHD presents with a painful leg that is pale, tingling (paraesthesia), paralysed and (perishingly) cold

Answer 11

Acute lower limb ischemia

Question 12

A patient presents with sudden, excruciating pain that radiates to the back and collapse

Answer 12

Abdominal Aortic Aneurysm

Question 13

A patient presents with a unilateral, red, swollen, painful leg

Answer 13

DVT

Question 14

A patient with varicose veins presents with pain, tenderness, redness and swelling

Answer 14

Thrombophlebitis

Question 15

A few weeks after birth a baby is found to be failing to thrive and and become sweaty and tachypnoeic with feeds. On auscultation, a pansystolic murmur can be heard

Answer 15

Ventricular Septal Defect

Question 16

A 40 year old woman presents with decreased exercise tolerance, easy fatigability, palpitations, and dyspnoea. On examination she is found to have a RV heave and a pulmonary mid-systolic murmur

Answer 16

Atrial septal defect

Question 17

A baby in relatively good health a few days/weeks after birth presents with dyspnoea, tachycardia, a bounding pulse and a machine gun murmur on auscultation

Answer 17

Patent ductus arteriosus

Question 18

A male baby presents with breathing difficulties, poor appetite and failure to thrive. As he grows older he develops headaches, nosebleeds, fatigue, and diminished lower limb pulses. On CXR, rib-notching is seen

Answer 18

Coarctation of the aorta

Question 19

A child whose mother used alcohol/had diabetes/was >40/had rubella during pregnancy, develops cyanosis, difficulty breathing or loosing consciousness during crying or bowel movements

Answer 19

Tetralogy of Fallot

Question 20

A baby is born cyanosed and dies soon after

Answer 20

Transposition of the great vessels

Question 21

A teenager playing football suddenly drops dead. What is the most likely cause?

Answer 21

Hypertrophic cardiomyopathy

Question 22

A patient presents with heart failure, excessive fatigue, arrythmias and a history of thromboembolism

Answer 22

Dilated cardiomyopathy

Question 23

What genetic cardiac condition is asymptomatic in its early stages but can cause syncope, ventricular arrhythmias and RHF in the later stages?

Answer 23

Arrhythmogenic right ventricular cardiomyopathy

Question 24

What genetic heart condition can cause heart failure symptoms + hepatic enlargement and ascites

Answer 24

Restrictive cardiomyopathy

Question 25

A young man who has just had a viral infection presents with shortness of breath, fatigue, palpitations, chest pain and loss of consciousness

Answer 25

Myocarditis

Question 26

A young man experiences a fever, shortness of breath, nausea and chest pain that’s worse on lying down and better on learning forward.

Answer 26

Pericarditis