Symptoms of CARDIOVASCULAR DISEASES

1. Symptoms of CVD
Professor Salwa Ibrahim
Cairo University

2. Pulmonary congestion

3. Dyspnea
• Awareness of breathing
• Normal on exercise
• May be caused cardiac,
respiratory, metabolic
conditions, anxiety
• Cardiac patients develop
dyspnea because of fluid
accumulation in the alveoli

4. Orthopnoea
• Dyspnea on lying flat relieved by sitting
• Lying flat increases venous return to the heart
• Can be graded by the number of pillows

5. Paroxysmal Nocturnal Dyspnea
• Sudden breathlessness which wakes the patient from sleep
choking or gasping air
• Caused by gradual accumulation of alveolar fluid during sleep
• Patients may sit on the edge of the bed and open windows in
an attempt to relieve their distress.
• Cough with frothy blood stained sputum
• Chest wheezes

7. Systemic venous congestion

8. LOWER LIMB EDEMA
• Caused by systemic venous congestion
• Dependent edema, lower limbs and sacral
• Bilateral pitting edema

9. Differential diagnosis of bilateral LL edema
• Congestive heart failure
• Nephrotic syndrome
• Liver cirrhosis
• Renal failure

10. Differential diagnosis of unilateral leg swelling
• DVT
• Lymphatic obstruction
• Cellulitis

11. ABDOMINAL DISTENSION
• Ascites secondary to systemic venous congestion
• Occurs before edema in TR

12. Palpitation

13. PALPITATION
• Awareness of heart beats
• Change in the rate or the rhythm
• Check onset, duration, relation to exertion, irregularities
• Normal during exercise, anxiety, coffee, nicotine

14. Irregularities
• Atrial extrasystoles
• Ventricular extrasystoles
• Atrial fibrillation

15. TACHYCARDIA
• SINUS TACHYCARDIA
• VENTRICULAR TACYCARDIA

16. BRADYCARDIA
• SINUS BRADYCARDIA
• HEART BLOCK

17. HIGH PULSE VOLUME
• AORTIC REGUREG
• THYROTOXICOSIS
• PREGNACY
• ANEMIA

18. Chest Pain

19. Angina pectoris
• Diffuse Dull discomfort felt in the centre of
anterior chest
• Duration less than 10 minutes
• Tightness, pressure similar to carrying heavy
weight
• May radiate to left arm, jaw and teeth
• Associated with sweating, palpitation
• Triggered by exercise, cold weather
• Relieved by rest, nitroglycerin sublingual

21. Unstable angina
• Angina of recent onset
• Increasing severity
• Angina at rest
• Is a medical emergency as it precede Myocardial infarction

22. Myocardial infarction
• Severe chest pain
• Prolonged duration
• Not relieved by rest or nitroglycerin
• Pallor, nausea, vomiting
• Pain may be absent in 30% particularly in the diabetics and
old age

23. Pericarditis
• Sharp stitching anterior central chest pain
• Increases by inspiration and movement
• Decreases by leaning forward

24. Aortic dissection
• Tear in the intimae of the aortic wall
• Abrupt severe chest pain (interscapular) radiates to back
• MI if ascending aorta is involved
• Syncope and focal neurological defects

25. Gastroesophgeal reflux
• Retrosternal or epigastric pain
• Burning sensation
• Increased on lying down
• Relieved by antacids

26. Low cardiac output

27. LOW CARDIAC OUTPUT
• Syncope is a faint with
transient loss of
consciousness
• Caused by decrease
blood flow to the brain
• Caused by obstructive
lesions (aortic stenosis),
rhythm disturbance
(heart block) or fast
arrhythmia

28. Embolic manifestations

29. EMBOLIC MANIFESTATIONS
• Stroke
• TIAs (aphasia, sensory, motor
deficits lasting few hours)
• Atrial fibrillation causes left
atrial thrombus with
microemboli to cerebral
circulation

30. Infective endocarditis

31. Infective endocarditis
• Fever
• Weight loss
• Night sweats
• History of rheumatic valve
disease