Histroy taking in cardiac cases

History Takingin

Cardiac CasesShahid Abbas

Interventional cardiologist and Physician

Introduction ?

Introduction

Name

Age

Occupation

Residence

Presenting Complaints

1 or 2

How to ask ?

H/o present Illness

• How to start ?

• Detail of PC and all the pertaining IssuesMissed D/D

Chest Pain ?

Chest Pain• Intensity

• Pattern

• Location

• Duration

• Radiation

• Aggravating/ relieving F

• Frequency

• Progression

• D/D

• ACS

• Pneumonia

• PE

• Dissection of Aorta

• APD GERD

• Costochondritis

Associations

• Sweating

• Palpitations

• Fever

• Breathlessness

• vomiting

Breathlessness ?

Breathlessness• NYHA

• Orthopnia /PND (No of Pillows)

• Palpitations

• Oedema feet

• Abd Distension

• Otners

• Life style modification

• Fever

• Hemoptysis

• D/D

• LVF

• COAD/ Br Asthma

• Infections/TB

• PEmbolism

Palpitation ?

Palpitation• Frequency

• Rhythem

• Micturtion reflex

• DC cardioversion

• Embolic

• Drugs

• CVA

• Kid

• Gut

• Limb

MI ?

Risk Factors

• DM

• HTN

• Smoking

• Dyslipedemia

• Family History

• Menopause

CAD equivalents

• DM

• Abd Aortic aneurysm

• PVD

• Symptomatic Carotid Artery disease

Cardinal points

• Dizziness Syncope

• CVA

• Carotid Artery Disease

• Chest Pain

• Breathlessness

• Palpitations

• MI

• Intermittent Claudication

• Oedema Feet

Systemic review

Co-Morbidity

COAD

Br Astma

CLD

CKD

Contraindications to stenting

Investigations

Results

Treatment

Compliance

Response to medications

Side effects

Admissions

Drug Allergies

Personal / family History

Exercise

Smoking

Alcohol

Marital Status

Kids

Socioeconomic Bracket

Pace Makers

• Old Documents

• 1 Lead or 2 Leads

• Syncope

• Pus discharge from pocket - I/v Drugs Antibiotics

• Pace Maker follow up trouble shooting

• Threshold

• Sensing not possible in demand mode

• Anticoagulation (AF + Pacing)

Pace Maker (Cont)

• Hysteresis

• Bipolar pacing

• Magnet VOO

• Over sensing/ under sensing

VHD

Presenting Symptoms

• decompensation

First symptom

Breathlessness

• Orthopnia

• Life style modification

• Otners synd

• Wheeze

• Palpitation

VHD (cont )

Chest Pain• Angina

• IHD risk Factor

Hemoptysis

• Fever

• Pulm oedema

• Chest Pain (infarction/ Embolism)

VHD (cont )

IE• Fever duration response to Medications

• Admission

Thrombo-Embolism• Palpitations

• KID

• CVA

• Gut

• Limbs

VHD (cont )

Progression of Disease

Rehumatic Fever Child hood• Sore throat

• Joint pains

• Monthly painful Inj

Admissions in the Past

Investigations• Xray Chest

• ECG, ECHO

VHD (cont )

Treatment• Compliance

• Response

• Side effects

Functional Disabilty

Class 0

Class I

ClassII

Class III

Class IV

• Transfer

• Dressing

• Wash room utility

• Ablation

• Eating

Thank You