This document summarizes common symptoms of cardiovascular disease (CVD). It describes symptoms such as dyspnea (shortness of breath), orthopnea (difficulty breathing when lying flat), paroxysmal nocturnal dyspnea (sudden breathing issues at night), edema (swelling) in the lower limbs, abdominal distension, palpitations, chest pain, low cardiac output causing syncope (fainting), embolic manifestations like stroke, and symptoms of infective endocarditis (heart valve infection) like fever and weight loss. The document provides details on the causes and characteristics of each symptom to aid in differential diagnosis of potential cardiac or pulmonary conditions.

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