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Chapter: Medicine Study Notes : Cardiovascular

History - Cardiovascular

Major symptoms: o Chest pain/heaviness/discomfort o SOB (exertional, orthopnoea, PND) o Ankle swelling o Palpitations (due to ­EDV, or do they mean arrhythmia – usually sudden onset – or tachycardia – usually gradual onset) o Syncope o Intermittent claudication (pain in legs on exertion due to ischaemia) o Fatigue

History

 

·        Major symptoms:

o  Chest pain/heaviness/discomfort

o  SOB (exertional, orthopnoea, PND)

o  Ankle swelling

o  Palpitations (due to ­EDV, or do they mean arrhythmia – usually sudden onset – or tachycardia – usually gradual onset)

o  Syncope

o  Intermittent claudication (pain in legs on exertion due to ischaemia)

o  Fatigue

·        Key differentials:

 

o  Does it change with breathing? (Þ ?respiratory cause)

o  Does it change with movement or localised pressure (Þ ?musculoskeletal cause)

 

·        Past history screen: Rheumatic fever, STDs, recent dental work, thyroid disease, history of heart disease, drugs

 

·        Social history: tobacco (ask „have you ever smoked‟ not „do you smoke‟ just in case they „gave up this morning‟), alcohol, occupation


·        Family history: Ischaemic heart disease, valve disease, congenital disease, Marfan‟s


·        Risk factors of Coronary Artery disease: hyperlipidaemia, smoking, hypertension, family history, diabetes mellitus, obesity, ¯exercise, male, advanced age

 

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Medicine Study Notes : Cardiovascular : History - Cardiovascular |


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