Cardiac Symptoms PDF

Cardiac symptoms Part II Palpitations • It is an abnormal subjective awareness of the heart beats. • These include feeling a rapid heartbeat, a pounding in the chest, a fluttering of the heart, being conscious of the beating of the heart, or feeling missed or skipped beats of the heart • Heart C...

Cardiac symptoms Part II Palpitations • It is an abnormal subjective awareness of the heart beats. • These include feeling a rapid heartbeat, a pounding in the chest, a fluttering of the heart, being conscious of the beating of the heart, or feeling missed or skipped beats of the heart • Heart Causes: 1- Changes in heart rate.(Tachycardia , Bradycardia) 2- Changes in rhythm. (arrhythmias ) 3- Changes in force . (heart failure, Cardiomyopathy ) Palpitations • Depending on the cause, palpitations can be : A- Short-term and disappear quickly, such as when palpitations occurs during an anxiety attack. B- Sudden, severe episodes, such as palpitations that happens with supraventricular tachycardia. C- Chronic and ongoing over a long period of time, such as when it is due to chronic atrial fibrillation. Palpitations • Palpitations often occur in conjunction with other symptoms, which vary depending on the underlying disease, include irregular pulse, chest pain, shortness of breath, cough, fever, abnormal vital signs, tachypnea and dyspnea. Ischemic Cardiac CHEST PAIN Non-ischemic Psychogenic Chest wall pathologic Pleuropulmonary Non-cardiac Mediastinal Diaphragmatic Abdominal Characteristics of chest pain due to angina Site & radiation Retrosternal & radiates to the left shoulder, inner side of the arm, elbow and left little finger. Character Constricting, squeezing or pressure on the chest Duration Usually 2-10 minutes, not seconds nor hours Factors precipitating pain Exertion, emotional stress or exposure to cold Factors Rest or nitroglycerine relieving pain Associated symptoms Sweating, dizziness General Examination General appearance Vital signs Vital colors Head & neck Skin & extremities Abdomen & Chest General appearance • Attitude in bed • General look and facies • Weight Vital signs Temperature DISCUSSED BEFORE • Causes of increase in temp. in cardiac patient include rheumatic activity, infective endocarditis, myocardial infarction, pericarditis, infection Blood pressure Pulse Heart rate Pallor: • • • • Vital colours Anemia due to chronic disease Peripheral vasospasm due to low cardiac output Infective endocarditis Cardiac infarction and shock Cyanosis • Bluish discolouration of the skin and mucous membranes Jaundice • • • • Cardiac cirrhosis of the liver Cardiac infarction Pulmonary infarction Artificial valve causing RBCs destruction Central cyanosis Peripheral cyanosis Site All the body Central: tongue, lips Peripheral: finger nails, skin of extremities warm Periphery only. Finger nails, skin of the extremities, lobule of the ear, tip of the nose Extremities Warm Usually cold Warmth Cyanosis doesn’t disappear Disappear Exercise Increase Improve (disappear) Inhalation of Oxygen Improve Doesn’t improve Clubbing Commonly present Absent Polycythemia Commonly present Absent Arterial Oxygen saturation Less than 85% Normal 95% Cyanosis Cyanosis • • Cyanosis is bluish discoloration of skin, nail beds and mucous membranes as a result from insufficient oxygenation , when arterial reduced Hb. Exceeds 5 g/dL(gram/decilliter) . Normally haemoglobin carries most of the oxygen in blood. This oxygen carrying capacity of haemoglobin in the blood (present in the arteries) is called oxygen saturation Types of cyanosis Central cyanosis • • • • • Central cyanosis is caused by diseases of the heart or lungs or by abnormal hemoglobin Peripheral cyanosis • may be seen in heart failure, ,exposure to cold temperatures and diseases of blood circulation. Lead to SaO2 , the aortic blood carrying reduced hemoglobin • Noticed in tongue , lips, ear lobes ,conjunctiva of the eyes • Warm extremities areas of the lips. There may be breathlessness, shallow or rapid breathing • Due to oxygenated blood flow through the peripheries . Noticed in fingers, cheeks, nose, and outer Cold extremities General Examination General appearance Vital signs Vital colors Head & neck Skin & extremities Abdomen & Chest • • Head and neck • • Congested neck veins Eye xanthelasma due to lipid deposition in inner canthus of eye lids, in cases of atherosclerosis. Puffy eyelids in cases of heart failure with myxedema Cyanosis or pallor Thank you