Symptomtology of cardiovascular diseases

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Symptomtology of cardiovascular diseases

  1. 1. SYMPTOMTOLOGY OF CARDIOVASCULAR DISEASES
  2. 2. SYMPTOMTOLOGY OF CARDIOVASCULAR DISEASES DYSPNEA CHEST PAIN PALPITATIONS DIZZINESS & SYNCOPE PERIPHERAL EDEMA SYSTEMIC SYMPTOMS 2
  3. 3. SYMPTOMTOLOGY OF CARDIOVASCULAR DISEASES 1)DYSPNEA DEFINITION  ONSET  Sudden  Ac. LVF  H.T.  M.I. Arrhythmia 3
  4. 4. DYSPNEA Onset- cont Gradual H.T. IHD VHD Fluid overload 4
  5. 5. 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 5
  6. 6. PAROXYSMAL NOCTURNAL DYSPNEA
  7. 7. DYSPNEA-cont NEW YORK HEART ASSOCIATION CLASSIFICATION GRADE-1 No breathlessness GRADE-2 Breathlessness on moderate exertion GRADE-3 Breathlessness on mild exertion GRADE-4 Breathlessness at rest 7
  8. 8. Symptomtology- cont 2) CHEST PAIN OR DISCOMFORT ANGINA PECTORIS M.I. PERICARDITIS AORTIC DISSECTION MISCELLANEOUS CAUSES 8
  9. 9. CHEST PAIN. Cont 1)ANGINA PECTORIS Cardiac pain due to myocardial ischemia  SITE  RADIATION  DURATION  CHARACTER  AGGRAVATING FACTOR  RELIEVING FACTORS  ASSOCIATED SYMPTOMS 9
  10. 10. Chest painANGINA. Cont 1)SITE & RADIATION CENTRAL OPEN HAND OR FIST(rather than pinpoint) EPIGASTRIC L- ARM,BOTH ARMS, JAW 10
  11. 11. SITE & RADIATION OF ANGINA
  12. 12. Chest painANGINA. Cont 2)DURATION & AGGRAVATING & RELIEVING FACTORS  5-20 minutes  Exertion  Excitement  Cold  Exercise after meal  Functional activity  Rest  GTN 12
  13. 13. Chest painANGINA. Cont CANADIAN CARDIOVASCULAR SOCIETYFUCTIONAL CLASSIFICATION Grade-1 No limitation Grade-2 Slight limitation Grade-3 Marked limitation Grade-4 Pain at rest 13
  14. 14. Chest painANGINA. Cont 3)CHARACTER Discomfort rather than pain Tightness Heaviness 14
  15. 15. Chest painANGINA. Cont 4)ASSOCIATED SYMPTOMS Dyspnea Sweating Vomiting Nausea Usually absent 15
  16. 16. Chest painANGINA. Cont TYPES OF ANGINA EFFORT ANGINA UNSTABLE ANGINA DECUBITUS ANGINA CRESCENDO ANGINA 16
  17. 17. Chest painANGINA. Cont ATYPICAL SYMPTOMS Risk factors Age Sex Smoking H.T. Diabetes 17
  18. 18. Chest pain -cont B ) MYOCARDIAL INFARCTION SITE & RADIATION SEVERITY DURATION PPT. FACTORS RELIEVING FACTORS ASSOCIATED SYMPTOMS PAINLESS M.I. 18
  19. 19. Chest pain -cont C-PERICARDITIS More localized(Central or lateral chest wall) Sharp-Stabbing or raw No radiation Changes with breathing & posture Improves with NSAID’S Preceded by viral illness 19
  20. 20. Chest pain -cont D-AORTIC DISSECTION H/O H.T., Marfans synd,Aortic aneurysm,Chest trauma Sudden Central –b/w scapulae Tearing Associated features 20
  21. 21. Chest pain -cont E- MISCELLANEOUS CHEST PAIN CAUSES Precordial catch (Da-Costa’s synd.) M.V.P. 21
  22. 22. Symptomtology- cont C- PALPITATIONS Awareness of heart beat SINUS RHYTHM SUSTAINED ABNORMAL RHYTHM OCCASIONAL IRREGULARITIES OF RHYTHM All patients of arrhythmia may not be symptomatic(A.F.) 22
  23. 23. PALPITATIONS-cont ASK ABOUT: Onset & termination Triggering factors Exercise Alcohol Caffeine Anxiety Frequency Duration of attack Rhythm Associated features 23
  24. 24. PALPITATIONS-cont a) Palpitations in sinus rhythm EXERCISE ANXIETY STRESS CAFFIENE SMOKING NIGHT TIME 24
  25. 25. PALPITATIONS-cont b) SUSTAINED ABNORMAL RHYTHM Sudden Minutes to hours Unrelated to anxiety ASK ABOUT: Family h/o sudden death Past h/o I.H.D. Drugs 25
  26. 26. PALPITATIONS-cont c) ECTOPIC BEATS Felt as missed beats Ventricular Benign in 10-15 % At rest Disappear with exercise Atrial 26
  27. 27. Symptomtology- cont 4)SYNCOPE & DIZZINESS Dizziness- non cardiac Syncope Pre-syncope CARDIAC Cardiac causes of syncope  Postural hypotention  Arrhythmia  L.V. Outflow obstruction 27
  28. 28. Syncope- cont 1)Postural hypotention Definition Drugs Dehydration A.N. Neuropathy 28
  29. 29. Syncope- cont 2)Arrhythmias Bradyarrythmias Sick sinus synd. CHB Drugs Ventricular tachycardias 29
  30. 30. Syncope- cont 3)L.V. Outflow obstruciton Severe A.S. H.O.C.M. 4)Other cardiac causes Enhanced vagal sensitivity(Bradycardia + Vasodilatation)  Fright  Fear  Micturition  Cough Carotid sinus hypersensitivity  Uncommon  Elderly  Atrial myxoma 30
  31. 31. Symptomtology- cont 5)PERIPHERAL EDEMA Symptom Sign ANKLE Unilateral  DVT  Cellulites  Trauma  Hemiplegia 31
  32. 32. Edema- cont. Bilateral CCF Hypoprotenemia Lymph. Obstruction I.V.C. obstruction Immobility SACRAL GENERALISED 32
  33. 33. Symptomtology- cont 6)SYSTEMIC SYMPTOMS a) Fatigue     Heart failure Sustained arrhythmia Cyanotic heart disease Drugs b)Anorexia THE END 33

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