Symtomps and Sign

7/30/2019 Symtomps and Sign

1/6

SYMTOMPS AND SIGN

OF THE CARDIAVASCULAR

HISTORY TAKING AND PHYSICAL DIAGNOSIS

OF THE CARDIVASCULAR

ALL ASPAR MPPAHNYA

MEDICAL HISTORY TAKING

IN CARDIAVASCULAR

GOALS

A. Establish rapport with the patientB. Obtain diagnostic information about the patient

1. pertinent information that may lead to theestablishment of diagnosic

2. Asses the severity of the problem.3. Determine other sorces of information.4. Asses the patient`s personality traits5. Asses the patient`s level of understanding6. Asses the patint`s personal goals and

requirements with regard to activity

CHARECTERIZATION OIF SYSTEM

A.Patients can have heart disease without symtomps,or they canhave symptoms that may be associated with noncardiacdiseases

B.The characteristic features of all symtomps should be obtainedin detail to provide the maximum information.Questioning

about each symptoms (e.g.,chest pain ) should include :


2/6

1. Location and radiation2. Quality

3. Quantity (severity,frequency and duration)4. Chronology (onset and development)5. Setting and recurrence (time of day,activity,and emotional

state)6. Aggravating and alleviation factors7. Associated symptoms8. Aesponse to any particular medication

THE SYMPTOMS MOST FREQUENTLY EXPERIENCED BY

PATIENTS WITH CARDIOVASCULAR DISEASE :

1. CHEST PAIN

2. PAIN IN THE EXTREMITIES

3. DYSPNEA

4. PALPITATIONS

5. SYNCOPE,NEAR SYNCOPE OR DIZZINES

6. FATIGUE

7. HEMOPTYSIS8. CYANOSIS

9. EDEMA (ANKLE EDEMA)

CHEST PAINT

A.ANGINA PECTORIS

1. AP is characterized by paroxysmal attacks of chest discomfort

that occur when coronary blood flow is inadequate to meet the

metabolic demands of the hearts.

2. The pain occurs retrosternally and frequently radiates into the

neck,jaw,and upper exterminates.it often radiates across the

precordium to yhe left shoulder and upper arm.

3. Angina is usually described as being dull and constant.it has

been described as constricting,boring,pressing,or expanding.it


3/6

also often expressed as a burnig sensation,indigestion or

heatburn.

4. The pain maybe mild to excruciating,and occurs with variable

frequency.

5. Attackas of angina pectoris usually last only a few

minutes.sublingual nitroglycerine usually relieves the pain

within 3 minutes.

6. The attacks usually occur during physical exertion,emotional

stress,exposure to culd weather,or following meals.the pain may

occur at rest (angina decubitus )or awaken the patient from

sleep (nocturnal angina)7. Tnginal pain may be accompanied by palpitation,dizziness,and

nausea.

8. Angina accoring with increasing frequency or severity has been

referred to as unstable angina or crescendo angina and this

type of angina often occurs even at rest.

9. Coronary artery spasm may occur with or without fixed

coronary artery lesions.the pain like this occurs at rest

ratherthan with mild exertion or emotional exciterment.it

frewquently occurs during the night,awakening thr patient fromsleep

10.When an anginal attack is not delieved by rest and two and

more sublingual nitroglycerine,suspect inpending myocardinal

infarction (MI) and treat the patientin the coronary care unit

until diagnosis is proven otherwise.

B.MYOCARDINAL INFARCTION

The pain of MI differs from that of AP in several ways :

1. Severity : it usually more severe

2. Duration : the pain can persist for hours and occasionally,as a

mild distcomfort,preasure sensation,or sereness,for 1 and 3

days or even longer.

3. Relationship to activity : it usually occurs at rest.

4. Response to nitrolycerine : the pain is usually not relieved by

this medication.


4/6

5. Associated to other symtomps : chest pain is frequently

associated with various over serious manifestation of

cardiogenic shock,acute congestive heart failure (CHF),and

life-thereatening cardiac arrhythmias.

C. PERICARDITIS

1. The pain in sharp and frequently severe

2. It is located precordially and may radiate into the soulder

and neck.

3. It is exacerbated by taking a deep breath or turning fromside to side.leaning forward my lessen the chest

discomfort.

4. The nature of chest pain and other associated findings my

vary considerably,depending upon the underlying

disorders (e.g. viral pericarditis,bacterial pericarditis,post

myocardinal infaction syndrome,postcardiotomy

syndrome,uremy pericarditis,pericarditis associated with

malignancy,tuberculous pericarditis,etc)

D. MYOCARDITIS AND CARDIOMYOPATHIES

1. Myocarditis and cardiomyopathies my cause chest

pain,depending upon the underlying disorder.

2. Myocarditis is often associated with pericarditis and the

chest pain under the circumstances is usually similar,if

not identical,to pain inpure pericarditis.

3. Chest pain and even electrocardiographic findings ofcardiomyopathies may closely resemble acute MI.

E. PULMONARY EMBOLISM

1. Most small pulmonary emboly produce little or no chest

pain.

2. The of pulmonary embolism is usually sharp,begins

suddenly,is aggravated by breathing.


5/6

3. It is usually accompanied by significant dyspnea.

4. A history of rtecent surgery,pregnancy,trauma,bed

rest,prolonged sitting or standing,or use of oral

contraceptives (often associated with smoking) may help

in making the diagnosis.

F. DISSECTION OF THE AORTA

1. the pain sharp,sudden,excruciating,and most severe at the

onset.it is often described as tearing,or ripping.

2. its location is in the anterior chest,but it frequently

radiates into the back or the abdomen.3. it is not aggravated by breathing

4. symptoms of vascular occlusion frecuently follow

F MYRAL VALVE PROLPASE SYNDROME (BARLOW`S

SYNDROME)

1.Chest pain associated with MVP syndrome is usually

sharp,brief,unrelated to exertion,and located near the apex or left

lateral chest.2.it may be associated with palpitation, dyspnea, fatigue, and dizzy

spells.

3.it may mimic the pain of AP or MI , but it usually produces atypical

chest pain.

G.PSYCHONEUROTIK PROBLEMS

1. various psychoneurotic disorders frequently produce atypical chest

pain


6/6

Documents

Symtomps and Sign