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Cardiovascular System History Cheat Sheet (DRAFT) by

FESIJJJ jnnsd dkjsak

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Introd­uction:

W
Wash Hands
I
Introduce Yourself + Patient's Identity
P
Permission
P
Patient Position + Pain
E
Explai­­­n­ation

Basic Patient Inform­ation:

Name
Age
Date of Birth
Gender
Date Seen

Presenting Complaint:

Chest Pain
Dyspnoea
Orthopnea:
Breath­les­sness on lying down
(Number of pillows required)
Paroxysmal Nocturnal Dyspnoea:
Waking suddenly at night due to breath­les­sness, gasping for air
Palpitations:
Premature beats are felt by the patient as a pause followed by a forceful beat

Paroxysmal tachyc­ardias start abruptly and may be felt as a sudden racing heartbeat

Bradyc­ardias may be apprec­iated as slow, regular, heavy or forceful beats
Syncope:
Transient loss of consci­ousness due to inadequate cerebral blood flow:
• Vascular (Ortho­sta­tic­/au­ton­omic)
• Obstru­ctive
• Arrhythmic
Fatigue:
Symptom of inadequate systemic perfusion in heart failure
Peripheral Oedema:
• Heart failure (salt and water retention)
• Renal underp­erf­usion + activation of the renin-­ang­iot­ens­in-­ald­ost­erone system
Angina:
Squeezing, pressure, heaviness, tightness or pain in the chest

History of Presenting Complaint:

Duration
Associated Features
Chest Pain:
SOCRATES

Enquire about:
• Back Pain
• Shoulder Pain
• Jaw Pain
• Pain between the shoulder blades
Orthopnea:
Number of pillows
Also enquire about:
• Sputum
• Fatigue
• Exercise Intole­rance
• Weight Loss
• Pallor

Risk Factors:

Medica­tions that may have side effects that affect cardiac function
Age
Gender
Family History of Ischaemic Heart Disease:
• Who was affected and at what age?

•Did they have a heart attack and are they still alive?
Previoius Angina/MI/TIA/Stroke
Smoking
Alcohol
Diabetes
Hypert­ension
High Choles­terol or trigly­cerides
Lack of Exercise
Stress
Ask about risk conditions in first degree relatives:
• Sudden or premature death
• Hypertension
• Diabetes
• Cholesterol
• Angina/MI/TIA/Stroke
• Peripheral Vascular Disease
•Abdominal Aortic Aneurysm
Organic Solvents Exposure:
• Arrythmias
• Cardio­myo­pathy

Potential Differ­ential Diagno­sises:

Myocardial Infarction
Unstable Angina:
Unexpc­ect­ed/­Une­xpl­ained angina with no pattern
Stable Angina:
Angina that has a trigger e.g. exercise, etc.
Gastro­ent­eritis
Reflux
Aortic Stenosis:
Narrowing of the aortic valve opening
Acute Perica­rditis:
Painful inflam­mation of the perica­rdium
Anxiety Disorders
Dilated Cardiomyopathy:
Enlarged (parti­cularly left) ventricles
-Ventricles become stretched and thin
Asthma
Esopha­gitis:
Inflam­mation of the esophagus
Hypert­ensive Emerge­ncies:
Myocar­ditis:
Inflammed Myocardium

Additional Invest­iga­tions:

ECG
Chest X-ray
Full Blood Count/­Cho­les­ter­ol/­Fasting Blood Glucose
Echoca­rdi­ography
Markers of Myocardial Necrosis:
• Creatinine Kinase
• Cardia­c-s­pecific Troponins

Conclu­sion:

Ideas, Concerns, and Expect­ations
Thank patient and ensure comfort