Cvs - clinical notes

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Cardiovascular System DETAILS OF PRESENTING SYMPTOMS ! C"est C"est #ai$ #ai$ %c"est %c"est discom discom&or &ort'( t'( Ask for  •

•

Site, duration, character, radiation, aggravating & reliving factors Any special type of angina (unstable, second wind, nocturnal, pericardial  pain, aortic dissection) dissection) Type

Location

Character

A$)i$a Retrosternal onstricting pain %myocardial  pain radiating isc"emia' to arms, throat, Aggr by e!ertion & rapid relief by rest  jaw &drugs

A" # Atherosclerosis, arteritis, congenital A", embolism

Myocardial Same as i$&arctio$ angina

Same as angina but more severe & not easily relived

Acute myocardial infarction

Pericarditis entral (retrosternal) chest pain

Sharp $ Stabbing$ raw (like sand paper) pain

%diopathic, o!sackie  infection, complication of myocardial infarction

Pai$ o& aortic dissectio$

Severe tearing pain of abrupt onset

Aggr by deep radiate to inspiration, cough, shoulder $ back  postural change

•

Disease

Retrosternal $ over back in interscapular region

Aoric dissection

Grading  of  of Angina (anada heart dissociation)

%

Sever e!ertion

%%

'alking uphill $ climb imbing  flight of ordinary stairs

*6

%%%

'alking on on le level gr ground, cl climbing  flight of of ordinary stairs

%

At rest

*! Dys# ys#$oe oeaa  Def: Abnormal awareness of one-s own breathing at rest

$ low level of e!ertion

Ask for At rest$ after e!ertion .ime of occurrence/ day time$ nocturnal 0nset/ acute$ insidious Acut Acutee ons onset et Acut Acutee pul pulmo mona nary ry ed edem ema, a,  pulmonary embolism, embolism,  pneumothora!,  pneumothora!, pneumonia Subacute $ chronic

hronic 5

I

 2o dyspnoea at rest$ moderate e!ertion

II

"yspnoea at moderate to severe e!ertion

III

"yspnoea at mild e!ertion but minimal at rest

I+

Significant dyspnoea at rest/ often bed bound $ Severe dyspnoea on minimal e!ertion

Associated symptoms like cough, palpitation etc, Aggravating & relieving factors  2umber of episodes episodes Cardiac Cardiac Causes of Dyspnoea

"uration 1rading of dyspnoea/  234A class

*; 7 85 ("yspn ("yspnoea oea is the major major symptom symptom)) *7 conge congeni nita tall hear heartt dise diseas asee 97 ac:uir ac:uired ed valv valvula ularr heart heart diseas diseasee +7 A" 67 hyper hyperte tens nsiv ivee heart heart dise diseas asee ;7 card cardio iomy myop opat athy hy

I$ additio$ as, &or •

 PND • • • •

0ccurs at night