Signs and symptoms of heart disease

Question 1

What is the meaning of pathophysiology?

Answer 1

Functional changes (how body adapts to changes) eg with hypertension, heart has to work harder.

Question 2

What are the 6 types of heart disease?

Answer 2

-ischaemic
-valvular
-congenital
-myocardial
-pericardial
-hypertensive

Question 3

Why is appearance a sign of heart disease?

Answer 3

colouring of skin (grey), scars (from previous surgery), engorgement of liver (right heart failure).

Question 4

Why is skin temp a sign of heart disease?

Answer 4

Should be warm rather than cold and clammy (hands and feet get cold first to protect the core).

Question 5

Why is chest deformities a sign of heart disease?

Answer 5

Pectus exinartum etc

Question 6

What else is a sign of heart disease?

Answer 6

HR and rhythm.

Question 7

Cyanosis as sign?

Answer 7

Poor circulation (turns blue). Central cyanosis affects mucous membranes etc

Question 8

Clubbing as a sign?

Answer 8

Seen with congenital, low levels of O2.

Question 9

Peripheral oedema as a sign?

Answer 9

If the LV is poorly contracting, pressure build up (sign of poor circulation and heart failure).

Question 10

What is an ambulant patient with peripheral oedema?

Answer 10

Patient is up and about (walking). Leads to oedemitis ankles due to gravity (push finger in- leave dimple). Leads to ulcers and sores.

Question 11

What is an immobile patient with peripheral oedema?

Answer 11

They stay in bed, leads to sacral oedema (collects at bottom of spine)- this stops blood flow.

Question 12

What are some other signs of heart disease?

Answer 12

JVP, arrhythmias, xanthelasma (lipids in eyelids- levels of cholesterol are too high). Retinopathy (cotton wool spots).

Question 13

What is the definition of a murmur?

Answer 13

any abnormal acceleration or deceleration of blood through the heart (other heart sounds). These are always in relation to the cardiac cycle.

Question 14

What is the meaning of oscillating?

Answer 14

Listening for hear sounds.

Question 15

What are the types of heart murmurs?

Answer 15

-ejection type
-pansystolic
-late systolic
-early decrescendo
-mid to late
-prolonged mid to late

Question 16

Chest pain as a symptom of heart disease?

Answer 16

-stable angina- experience chest pain with activity and stops when at rest (squeezing, crushing, gripping)
(demand is higher than the supply)
-unstable angina- comes at rest, more frequent (acute coronary syndrome) -high intensity, 2-3 weeks
-MI- cell death (nauseous, sweating, hypotensive)

Question 17

Shortness of breath as symptom?

Answer 17

-dyspnoea
-orthopnoea (lying flat, hydrostatic pressure taken away, RA becomes congested)
-paroxysmal nocturnal dyspnoea- middle of night having trouble breathing (interstitial fluid back in the nervous system)
-haemoptysis (blood going back to lungs, pulmonary capillaries rupture and blood bleeds into alveoli- therefore cough up blood)

Question 18

Palpitations as symptom?

Answer 18

higher awareness of heart beating (ectopic activities, bradycardia and tachycardia)

Question 19

Syncope as symptom?

Answer 19

-lose consciousness
-pre-syncopal (think they’re about to lose consciousness)
-heart can cause loss in consciousness
-vasovagal (faint)- neurally mediated
-postural hypotension (stand up too fast).

Question 20

Fatigue as a symptom?

Answer 20

-tired, low exercise tolerance
-low CO

Question 21

What is the differential diagnosis for chest pain?

Answer 21

-pericardium (caused by pericarditis)
-aorta (dissecting aneurysm)
-large bronchi (bronchitis)
-parietal pleura (pleurisy)
-oesophagus chest wall (reflux and spasm, musculoskeletal system)
-psychological