symptomtology of cardiovascular diseases
DESCRIPTION
CVSTRANSCRIPT
SYMPTOMTOLOGY OF CARDIOVASCULAR
DISEASES
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SYMPTOMTOLOGY OF CARDIOVASCULAR
DISEASESDYSPNEACHEST PAINPALPITATIONSDIZZINESS & SYNCOPEPERIPHERAL EDEMASYSTEMIC SYMPTOMS
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SYMPTOMTOLOGY OF CARDIOVASCULAR DISEASES
1)DYSPNEADEFINITION ONSET Sudden
Ac. LVF H.T. M.I.Arrhythmia
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DYSPNEAOnset- cont
GradualH.T.IHDVHDFluid overload
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DYSPNEA-cont
AGGRAVATING FACTORS RELIEVING FACTORS ORTHOPNEA Dyspnea on lying flat PND Dyspnea occurs suddenly ½ hr. to 4 hr.
after going to bed & is relieved after 10 –20 minutes
PAROXYSMAL NOCTURNAL DYSPNEA
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DYSPNEA-cont
NEW YORK HEART ASSOCIATION CLASSIFICATION
GRADE-1 No breathlessnessGRADE-2 Breathlessness on moderate
exertionGRADE-3 Breathlessness on mild
exertionGRADE-4 Breathlessness at rest
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Symptomtology- cont
2) CHEST PAIN OR DISCOMFORTANGINA PECTORISM.I.PERICARDITISAORTIC DISSECTIONMISCELLANEOUS CAUSES
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CHEST PAIN. Cont
1)ANGINA PECTORISCardiac pain due to myocardial ischemia
SITERADIATIONDURATIONCHARACTERAGGRAVATING FACTORRELIEVING FACTORSASSOCIATED SYMPTOMS
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Chest pain-ANGINA. Cont1)SITE & RADIATION
CENTRALOPEN HAND OR FIST(rather than
pinpoint)EPIGASTRICL- ARM,BOTH ARMS, JAW
SITE & RADIATION OF ANGINA
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Chest pain-ANGINA. Cont
2)DURATION & AGGRAVATING & RELIEVING FACTORS
5-20 minutesExertionExcitementColdExercise after mealFunctional activityRestGTN
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Chest pain-ANGINA. Cont
CANADIAN CARDIOVASCULAR SOCIETY- FUCTIONAL CLASSIFICATION
Grade-1 No limitation
Grade-2 Slight limitation
Grade-3 Marked limitation
Grade-4 Pain at rest
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Chest pain-ANGINA. Cont
3)CHARACTERDiscomfort rather than painTightnessHeaviness
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Chest pain-ANGINA. Cont
4)ASSOCIATED SYMPTOMS
Dyspnea
Sweating
Vomiting Usually absent
Nausea
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Chest pain-ANGINA. Cont
TYPES OF ANGINAEFFORT ANGINAUNSTABLE ANGINADECUBITUS ANGINACRESCENDO ANGINA
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Chest pain-ANGINA. Cont
ATYPICAL SYMPTOMS
Risk factors
Age
Sex
Smoking
H.T.
Diabetes
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Chest pain -cont
B ) MYOCARDIAL INFARCTIONSITE & RADIATIONSEVERITYDURATIONPPT. FACTORSRELIEVING FACTORSASSOCIATED SYMPTOMSPAINLESS M.I.
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Chest pain -cont
C-PERICARDITISMore localized(Central or lateral chest wall)Sharp-Stabbing or rawNo radiationChanges with breathing & postureImproves with NSAID’SPreceded by viral illness
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Chest pain -cont
D-AORTIC DISSECTIONH/O H.T., Marfans synd,Aortic
aneurysm,Chest traumaSuddenCentral –b/w scapulaeTearingAssociated features
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Chest pain -cont
E- MISCELLANEOUS CHEST PAIN CAUSES
Precordial catch (Da-Costa’s synd.)M.V.P.
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Symptomtology- cont
C- PALPITATIONSAwareness of heart beatSINUS RHYTHMSUSTAINED ABNORMAL RHYTHMOCCASIONAL IRREGULARITIES OF
RHYTHMAll patients of arrhythmia may not be
symptomatic(A.F.)
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PALPITATIONS-cont
ASK ABOUT:Onset & terminationTriggering factors
ExerciseAlcoholCaffeineAnxiety
FrequencyDuration of attackRhythmAssociated features
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PALPITATIONS-cont
a) Palpitations in sinus rhythmEXERCISEANXIETYSTRESSCAFFIENESMOKINGNIGHT TIME
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PALPITATIONS-cont
b) SUSTAINED ABNORMAL RHYTHMSuddenMinutes to hoursUnrelated to anxietyASK ABOUT:
Family h/o sudden deathPast h/o I.H.D.Drugs
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PALPITATIONS-cont
c) ECTOPIC BEATS
Felt as missed beatsVentricular
Benign in 10-15 %At restDisappear with exercise
Atrial
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Symptomtology- cont
4)SYNCOPE & DIZZINESSDizziness- non cardiacSyncopePre-syncope CARDIAC
Cardiac causes of syncopePostural hypotentionArrhythmiaL.V. Outflow obstruction
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Syncope- cont
1)Postural hypotentionDefinitionDrugsDehydrationA.N. Neuropathy
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Syncope- cont
2)ArrhythmiasBradyarrythmias
Sick sinus synd.CHBDrugs
Ventricular tachycardias
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Syncope- cont
3)L.V. Outflow obstrucitonSevere A.S.H.O.C.M.
4)Other cardiac causesEnhanced vagal sensitivity(Bradycardia + Vasodilatation)
Fright Fear Micturition Cough
Carotid sinus hypersensitivity Uncommon Elderly Atrial myxoma
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Symptomtology- cont
5)PERIPHERAL EDEMASymptomSignANKLEUnilateral
DVTCellulitesTraumaHemiplegia
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Edema- cont.
BilateralCCFHypoprotenemiaLymph. ObstructionI.V.C. obstructionImmobility
SACRALGENERALISED
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Symptomtology- cont
6)SYSTEMIC SYMPTOMSa) Fatigue
Heart failure Sustained arrhythmia Cyanotic heart disease Drugs
b)Anorexia
THE END