History Taking Cardiovascular System Flashcards Preview

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Flashcards in History Taking Cardiovascular System Deck (32)
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1

According to Dr Bernard Lown what percentage of patient encounters can be diagnosed by the medical history?

75%

2

What are the 5 steps of Roger Neighbour's consultation model?

1. Connecting
2. Summarising
3. Handing over
4. Safety netting
5. Housekeeping

3

What conditions may you specifically ask for in a cardiovascular examination ?

- History of vascular disease
- Diabetes
- Hyperthyroidism
- Renal disease
- Hypertension
- Hypercholesterolaemia

4

How do you calculate pack years?

(No. of cigarettes smoked per day X No. of years smoking) / 20

5

What should you include in a systems enquiry?

- Chest pain
- Breathlessness (including orthopnoea and paroxysmal nocturnal dyspnoea)
- Palpitations
- Syncope / dizziness
- Oedema
- Peripheral vascular symptoms
- Intermittent claudication

6

What are modifiable cardiovascular risk factors?

- High BP
- Smoking
- Diabetes melitus
- Physical inactivity
- Obesity
- High blood cholesterol

7

What are non-modifiable cardiovascular risk factors?

- Age
- Gender
- Genetic factors
- Race and ethnicity

8

What are the cardiovascular causes of chest pain?

- Stable angina
- Acute coronary syndromes
- Pericarditis
- Aortic dissection

9

What are the respiratory causes of chest pain?

- Pulmonary embolus
- Pneumothorax
- Pneumonia
- Lung cancer
- Mesothelioma

10

What GI disease can cause chest pain?

Oesophageal disease

11

What are the musculoskeletal causes of chest pain?

- Trauma - muscular or rib injury
- Chostochondritis

12

What conditions are included in as an acute coronary syndrome?

- STEMI
- NSTEMI
- Unstable angina

13

How do you differentiate oesophageal disease from angina pectoris

- Angina can radiate pain to jaw
- Angina is usually precipitated by exertion but oesophageal pain can be worsened but is usually present at other times
- Angina is rapidly relieved by rest
- Oesophageal disease often wakes patient from sleep angina rarely does
- Angina is typically 2-10 mins
- Oesophageal disease is related to heartburn

14

What percentage of percarditis is idiopathic?

80 -90%

15

How is aortic dissection pain usually described?

-Sudden and severe
- Tearing and deep
- Radiating to left shoulder / back

16

What is dyspnoea

Difficulty or trouble breathing

17

What are the cardiac causes of dyspnoea?

- Cardiac failure
- Associated with angina or MI

18

What are the causes of respiratory dyspnoea?

- Asthma
- COPD
- Pneumothorax
- Pneumonia
- Bronchitis
- Bronchiectasis
- Pulmonary fibrosis

19

What are the causes of dyspnoea that are not cardiac or respiratory related?

- Anaemia
- Obesity
- Hyperventilation
- Anxiety
- Metabolic acidosis

20

How can you differentiate dyspnoea?

- Acute, chronic or acute-onchronic
- At rest / on exertion / exercise tolerance?
- Orthopnoea / paroxysmal nocturnal dyspnoea (PND)
- Response to diuretic?
- Associated symptoms (e.g cough / sputum / chest pain /palpitations)

21

What is Paroxysmal nocturnal dyspnea (PND)?

A sensation of shortness of breath that awakens a patient often after 1 or 2 hours of sleep.

22

What underlying conditions can cause PND?

- (Heart failure)
- Ischaemic heart disease
- Aortic valve disease
- Hypertension
- Cardiomyopathy
- Atrial fibrilation
- Mitral valve disease
- Atrial tumours

23

What is orthopnea?

The sensation of breathlessness in the recumbent position, relieved by sitting or standing. Often a symptom of left ventricular heart failure and/or pulmonary oedema.

24

What is a heart palpitation?

An unexpected awareness of heart beating in chest.

25

What is postural/orthostatic hypotension?

When systolic blood pressure decreases by at least 20 mg Hg when going from lying down to flat

26

What conditions can cause dizziness and syncope?

- Postural hypotension
- Neurocardiogenic (vasovagal)
- Micturition syncope
- Cardiac arrhythmias

27

What is micturition syncope?

Fainting after urination

28

What factors should you consider when assessing oedema?

- Localised or generalised
- Are the legs unilateral or bilateral
- Duration
- Are there any aggravating or relieving factors

29

What is the most common cause of pitting oedema?

- Increased venous pressure (can also result from reduced oncotic pressure or may be idiopathic)

30

What conditions can cause bilateral oedema?

- Congestive cardiac failure
- Cor pulmonale
- Cirrhosis
- Acute renal failure
- Medication, for example, calcium-channel blockers
- Sepsis
- Myxoedema
- Pregnancy
- Idiopathic