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Questions and Answers
What is typically the cause of paroxysmal nocturnal dyspnea?
What is typically the cause of paroxysmal nocturnal dyspnea?
- Congestive heart failure (correct)
- Pneumonia
- Asthma attacks
- Pulmonary embolism
What type of sputum is typically associated with pulmonary edema?
What type of sputum is typically associated with pulmonary edema?
- Clear and watery
- Thick and yellow
- Brown and foul-smelling
- Frothy and blood-tinged (correct)
What is a common symptom of systemic congestion related to right heart failure?
What is a common symptom of systemic congestion related to right heart failure?
- Coughing up clear mucus
- Shortness of breath on exertion
- Swelling of the abdomen (ascites) (correct)
- Chest pain
Which symptom is indicative of low cardiac output and tissue hypoxia?
Which symptom is indicative of low cardiac output and tissue hypoxia?
Which of the following symptoms is NOT typically related to systemic congestion?
Which of the following symptoms is NOT typically related to systemic congestion?
Which aspect is NOT included in the detailed history of a patient's present illness?
Which aspect is NOT included in the detailed history of a patient's present illness?
What does orthopnea refer to?
What does orthopnea refer to?
Which of the following is a risk factor for coronary artery disease?
Which of the following is a risk factor for coronary artery disease?
In the context of pulmonary venous congestion, which manifestation is NOT typically associated?
In the context of pulmonary venous congestion, which manifestation is NOT typically associated?
Which symptom is considered first in the case of pulmonary congestion?
Which symptom is considered first in the case of pulmonary congestion?
Which of the following is NOT classified as a disease of the heart valves?
Which of the following is NOT classified as a disease of the heart valves?
How is 'grade 3 dyspnea' commonly characterized?
How is 'grade 3 dyspnea' commonly characterized?
What physiological change primarily causes dyspnea?
What physiological change primarily causes dyspnea?
What condition is characterized by the narrowing of the aorta?
What condition is characterized by the narrowing of the aorta?
Which type of tachyarrhythmia is characterized by rapid heart rate originating above the ventricles?
Which type of tachyarrhythmia is characterized by rapid heart rate originating above the ventricles?
Which of the following is NOT a symptom of cardiac disorders?
Which of the following is NOT a symptom of cardiac disorders?
Which type of myocardial disease is characterized by the heart's inability to pump effectively due to an enlarged heart muscle?
Which type of myocardial disease is characterized by the heart's inability to pump effectively due to an enlarged heart muscle?
In which condition would you expect an accumulation of fluid around the heart?
In which condition would you expect an accumulation of fluid around the heart?
Which of the following is a common symptom of coronary artery disease?
Which of the following is a common symptom of coronary artery disease?
What major diagnostic test is used to assess the electrical activity of the heart?
What major diagnostic test is used to assess the electrical activity of the heart?
Which of the following is NOT considered a type of congenital heart disease?
Which of the following is NOT considered a type of congenital heart disease?
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Study Notes
Cardiovascular Disease
- Includes disorders of heart rate, rhythm and conduction
- Includes diseases of the pericardium, the myocardium, the heart valves, and coronary artery disease
- Also includes vascular disease and congenital heart disease
Disorders of Heart Rate, Rhythm and Conduction
- Atrial tachyarrhythmias
- Supraventricular tachycardias
- Ventricular tachyarrhythmias
- Atrioventricular and bundle branch block
Coronary Artery Disease
- Stable angina
- Acute coronary syndrome
- STEMI
- NON STEMI
- UA
Vascular Disease
- Peripheral arterial disease
- Diseases of the aorta
- Hypertension
Diseases of the Heart Valves
- Rheumatic heart disease
- Mitral valve disease
- Aortic valve disease
- Tricuspid valve disease
- Pulmonary valve disease
- Infective endocarditis
Congenital Heart Disease
- Ventricular septal defect
- Atrial septal defect
- Patent ductus arteriosus
- Pulmonary stenosis
- Coarctation of aorta
- Aortic stenosis
- Tetralogy of Fallot
- Complete transposition of great arteries
Diseases of the Myocardium
- Myocarditis
- Cardiomyopathy
- Dilated cardiomyopathy
- Hypertrophic cardiomyopathy
- Restrictive cardiomyopathy
- Arrhythmogenic right ventricular cardiomyopathy
- Specific diseases of heart muscle
- Cardiac tumours
Diseases of the Pericardium
- Acute pericarditis
- Pericardial effusion
- Tuberculous pericarditis
- Chronic constrictive pericarditis
The Approach to Cardiac Diagnosis
- The cardiac history
- The cardiac physical examination
- Electrocardiogram
- Chest X-ray
- Echocardiography.Lab invx.RULES
- Patient should be allowed to tell their history in their own words
- Leading questions must be avoided unless the information cannot be obtained by other means
Patient History Taking
- Present History
- Includes detailed history of the patients current complaint
- Questions to address:
- Duration of symptoms
- Mode of onset (acute, subacute, chronic)
- Sequence of events
- Course of illness (progressive, regressive, or recurrent)
- Appearance of new symptoms or disappearance of others
- Treatment received during the course of the illness and response
- Analysis of each particular symptom
- Past History
- Childhood diseases (fever or joint pain, rheumatic fever)
- Drug therapy and operations
- Prior illness (cardiac or noncardiac)
- Recent dental work (infective endocarditis)
- Prior cardiac procedure
- Social and Family History
- Smoking and physical efforts
- Addiction
- History of the same illness within the family
- History of sudden death in the family
- Hereditary diseases
Coronary Artery Disease Risk Factors
- Cigarette smoking
- Age
- Sex
- Hypertension
- Hyperlipidemia
- Family history of CAD
- Diabetes mellitus
Symptoms of Cardiac Disorders
- Analysis of patient's complaint
- Cardiovascular Symptoms
- Symptoms of pulmonary venous congestion
- Symptoms of systemic venous congestion
- Symptoms of low cardiac output
- Chest pain
- Cyanosis and jaundice
- Palpitation
- Symptoms of peripheral vascular disease
- Toxic symptoms
- 1- Pulmonary Venous Congestion
- Causes: Left ventricular failure, mitral stenosis
- Manifestations:
- Dyspnea (shortness of breath)
- Orthopnea (dyspnea when lying flat)
- Paroxysmal nocturnal dyspnea (sudden onset of dyspnea at night)
- Cardiac asthma
- Cough
- Hemoptysis (coughing up blood)
- 2- Systemic Venous Congestion
- Causes: Right ventricular failure, pericardial disease
- Manifestations:
- Lower limb edema (bilateral, pitting edema starting in dependent parts, usually precedes ascites)
- Pain in the right hypochondrium and epigastrium (liver congestion)
- Dyspepsia (indigestion)
- Ascites (fluid buildup in the abdomen)
- Oliguria (reduced urine output)
- 3- Symptoms Due to Low Cardiac Output
- Causes: Tissue hypoxia (oxygen deprivation) affecting brain, muscles, and kidneys
- Manifestations:
- Exertional fatigue
- Dizziness and / or syncope
- Oliguria
- 4- Chest Pain
- Causes: Angina, pericarditis, aortic dissection
- Types:
- Angina (usually described as pressure or tightness)
- Pericarditis (sharp, stabbing pain that worsens with breathing)
- Aortic dissection (tearing, ripping pain that radiates to the back)
- 5- Cyanosis and Jaundice
- Causes:
- Cyanosis: low blood oxygen levels
- Jaundice: high levels of bilirubin in blood
- Causes:
- 6- Palpitation
- Causes: Irregular heartbeat, heart palpitations
- 7- Symptoms of Peripheral Vascular Disease
- Causes: Blockage or narrowing of arteries in the legs and feet
- Manifestations:
- Claudication (pain & cramping in legs or feet during exercise)
- Rest pain (pain that occurs even at rest)
- Coldness in extremities
- Poor wound healing
- 8- Toxic Symptoms
- Causes:
- Fever
- Night sweats
- Weight loss
- Fatigue
- Possible causes:
- Infective endocarditis
- Myocarditis
- Cardiac tumor
- Causes:
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