[email protected] 2. I – Symptoms of lung congestion: [email protected] 3...

Cardiology [email protected] 2

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I – Symptoms of lung congestion:


1- Dyspnea:- Due to difficult in inflation and deflation of congested

lung.- At first it occurs on sever exertion then in moderate &

later on mild.2- Orthopnea:

- It is dyspnea on lying down.- Mechanism: during lying down: - Increase venous return.- High position of the

diaphragm. - In ability or weakness or insufficient action of

accessory muscles of respiration.


3- Paroxysmal nocturnal dyspnea and pulmonary edema.

- The patient is awakened up after few hours of sleep by sever dyspnea, extreme anxiety.

- The associated symptoms are palpitation - Tachycardia – Tremors – pallor – excessive sweating and chest pain.

- In cases of pulmonary edema the patient cough and expectorates whitish sputum sometimes it may be blood tinged.

- The intensity of the symptoms is often described like suffocation and patients may get out of bed, occasionally throwing open the window to relief their distress.


4- Haemoptysis: Coughing of blood. 5- Recurrent winter bronchitis:

The patients get severe cough with expectoration of mucopurnlent sputum, usually during winter months, later on it may be all the year round.


Congested pulsated neck veins.Congested pulsated enlarged tender liver. Ascitis. Jaundice.Dyspepsia: sense of pain or discomfort after meal.

II- Symptoms of systemic congestion:


- Edema of the lower limb:A. Unilateral oedema:- Deep venous thrombosis.- Soft tissue infection.- Trauma .- Immobility: hemiplegia.B. Bilateral:- Heart failure.- Chronic venous in sufficiency.- Hypoproteinemia.- lymphatic obstruction.

III- Cardiac pain:


1- Angina:Cause.Characteristics: Burning- Refered2- Myocardial infarction:- Cause: coronary occlusion.-characteristics:

- Similar sites to angina.- More sever, persists at rest.


3- Pericardial pain:- Cause: Pericarditis.- Characteristics:- Sharp,Varies with movement. - More localized.4- Aortic pain:- Causes: dissection of aorta- Characteristics:

Sever sudden onset-- Tearing pain may cause

syncope.


B- Provoking factors: “Factors which precipitate pain“.C- Relieving factors:a) In case of angina, pain is relieved by rest or short acting coronary vasodilators. b) In myocardial infarction:

The pain may not be relieved except by morphine.D- Duration of pain:


IV- Low cardiac output symptoms:

This is caused by diminished blood supply to vital organs as:

1- Brain. 2- Myocardium. 3 – Retina . 4- Kidneys .

1- Giddness and dizziness particularly on exertion.2- Blurring of vision.3- Anginal pain.4- Oliguria " Diminished volume of urine"


Syncope:1- Postural hypotension:2- Arrhythmias.3- Left ventricular outflow obstruction:

- Sever aortic stenosis and hyper trophic cardiomyopathy are associated with obstruction of the left ventricular outflow tract.- It may cause syncope especially on exertion when cardiac out put fails to meet the increased metabolic demand.

V- Palpitation:- It is the sensation of the heart beat in the chest.- It may be in:1- Too rapid heart beats.2- Too slow heart beats.3- Too irregular heart beat4-Anxiety neurosis sensation:



VI- Mediastinal compression symptoms:

- Are due to compression of the mediastinal structures due to the following causes:1- Aortic aneurysm.2- Enlargement of cardiac chambers.3- Pericardial effusion.

The symptoms:Pressure over trachea → dyspnea .Pressure over the oesophygus → difficult in swallowing.Pressure over intercostal nerves → sever inter costal pain.Pressure over phrenic nerve → pain → increase severity of dyspnea.Pressure over vagus nerve → hoarseness of voice.Pressure over subclavian artery → ischemic pain in the limbs and inequality of the pulse.Pressure over large veins → symptoms of systemic congestion.



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[email protected] 2. I – Symptoms of lung congestion: [email protected] 3...

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