Symtomps and Sign
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Transcript of Symtomps and Sign
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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 :
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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
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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.
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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.
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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
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