Cardiac Disease Signs, Symptoms, Complications and Risk Factors

Sign

Objective evidence of disease that can be seen by others, such as edema or cyanosis.

Symptom

Subjective evidence of disease felt by the patient, such as a headache or chest pain.

Angina

Chest pain caused by myocardial ischemia.

Stable Angina

Chest pain controlled by nitroglycerin or by reducing/eliminating activity at the time of pain.

Unstable Angina

Chest pain that occurs while the patient is at rest.

Nitroglycerin

A medication used to control chest pain associated with stable angina.

Propranolol

A beta blocker medication that can be administered to treat angina.

Shortness of Breath (SOB)

Difficulty breathing while at rest.

Dyspnea on Exertion (DOE)

Difficulty breathing during exercise.

Orthopnea

Difficulty breathing when lying down, commonly associated with congestive heart failure.

Paroxysmal Nocturnal Dyspnea

Difficulty breathing that interrupts sleep, often seen with pulmonary edema.

Trepopnea

Difficulty breathing when lying on the left or right side.

Apnea

The cessation of breathing.

Hemoptysis

Bloody sputum caused by pulmonary edema and hemorrhage.

Cyanosis

Bluish discoloration of the skin and mucous membranes such as the lips and nail beds.

Clubbing

Bulbous enlargement of the fingers and toes that can result from cyanotic heart disease.

Edema

The accumulation of fluid in tissues or cells.

Pitting Edema

Edema characterized by the ability to indent the skin and a timed return to normal contour.

Pitting Edema Scale +1

The mildest form of pitting edema on a scale of $+1$ to $+4$.

Pitting Edema Scale +4

Pitting edema that allows deep indentation with very slow normalization of skin contour.

Brawny Edema

Non-pitting edema and skin discoloration occurring when chronic tissue edema leads to tissue fibrosis.

Bilateral Pedal Edema

Swelling in both feet commonly associated with right heart failure.

Venous Insufficiency (Legs)

Causes swelling in the affected legs but does NOT involve the feet.

Jugular Vein Distention (JVD)

Increased right heart pressure causing a back log of blood into the vena cava and its tributaries.

Pulsus Paradoxus

A drop in systolic blood pressure of $>10\,mmHg$ during inspiration.

Palpitations

The sensation of the heart pounding or fluttering, of which the patient is consciously aware.

Arrhythmia

An abnormal heart rate or rhythm.

Syncope

The medical term for fainting or passing out.

Murmur

An audible sound associated with turbulent blood flow across valves or defects.

Thrill

Palpable vibrations associated with loud, harsh murmurs.

Cachexia

An overall state of ill health, malnutrition, and wasting caused by chronic heart disease.

Troponin

A serum lab marker that, when elevated, indicates acute myocardial infarction.

Creatine Kinase-MB

A lab level usually increased during and for $24-48$ hours after an acute myocardial infarction.

Lactic Dehydrogenase (LDH)

A serum level used alongside troponin to diagnose myocardial infarction.

Hyperkalemia

Elevated potassium levels that cause reduced heart rate and strength of contraction.

Hypernatremia

Elevated sodium levels that cause reduced heart rate and strength of contraction.

Hypercalcemia

Elevated calcium levels that cause increased heart rate and strength of contraction.

Epinephrine

A substance that causes increased heart rate and strength of contraction.

Carnitine Deficiency

Inadequate intake or metabolism of carnitine, leading to impaired muscle metabolism and potentially dilated cardiomyopathy.

Staphylococcus aureus

A bacteria whose presence in blood work is a sign of infection.

Tinnitus

The medical term for ringing in the ears.

S1 (First Heart Sound)

Sound of the mitral and tricuspid valves closing after atrial contraction; occurs at the onset of the $QRS$ wave.

S2 (Second Heart Sound)

Sound of the aortic and pulmonic valves closing after ventricular contraction; occurs at the end of the $T$ wave.

S3 (Third Heart Sound)

A ventricular gallop caused by blood oscillation between ventricle walls; normal in children but abnormal after age $40$.

S4 (Fourth Heart Sound)

A presystolic or atrial gallop produced by blood forced into a stiff or hypertrophic ventricle during atrial kick.

Opening Snap

A heart sound associated with mitral stenosis, heard at the onset of diastole.

Ejection Click

A sound following $S1$ associated with congenital aortic or pulmonic valve stenosis.

Midsystolic Click

A heart sound occurring in mid to late systole associated with mitral valve prolapse (MVP).

Pericardial Rub

A friction sound caused by inflammation due to acute pericarditis.

Pericardial Knock

An early diastolic sound associated with constrictive pericarditis where the heart hits a rigid pericardial sac.

Functional Murmur

A murmur caused by rapid flow across a normal cardiac valve.

Pathologic Murmur

A murmur caused by turbulence across diseased cardiac valves or congenital defects.

Murmur Intensity Grade 1

A murmur that is barely audible.

Murmur Intensity Grade 6

A very loud murmur accompanied by a palpable thrill.

Systolic Murmur

A murmur occurring during the interval between $S1$ and $S2$.

Diastolic Murmur

A murmur occurring during the interval between $S2$ of one cycle and $S1$ of the next.

Holosystolic Murmur

A murmur that starts immediately after $S1$ and continues until the end of systole; seen with $MR$, $TR$, or $VSD$.

Systolic Ejection Murmur

A murmur that starts after $S1$ and increases in intensity; occurs when the valve is opening but NOT during isovolumic contraction.

Austin Flint Murmur

A functional diastolic murmur caused by significant aortic regurgitation vibrating the mitral valve.

Dock Murmur

An early diastolic murmur associated with stenosis of the Left Anterior Descending (LAD) artery.

Continuous Murmur

A murmur caused by flow throughout both systole and diastole, seen with Patent Ductus Arteriosus (PDA).

Valsalva Maneuver

A technique involving holding breath while constricting abdominal muscles, which decreases venous return.

Amyl Nitrite

A vasodilator that augments murmurs from $LVOT$ stenosis/$MVP$ and diminishes $AR$/$MR$ murmurs.

AIDS Cardiac Complication

Pericardial effusion is the most common cardiac complication of this viral disease.

Acromegaly

Pituitary gland overproduction of growth hormone leading to face/hand/foot enlargement and $LVH$.

Sigmoid Ventricular Septum

A change in the shape of the ventricular septum considered a normal part of aging.

Alcohol Abuse (Chronic)

Associated with reduced ventricular systolic function and dilated cardiomyopathy.

Ankylosing Spondylitis

An autoimmune disorder that can cause aortitis, aneurysm formation, and a dilated aortic root.

Beckwith-Wiedemann Syndrome

An overgrowth disorder present at birth that increases childhood cancer risk and can cause $LVH$.

Chagas Disease

A parasitic infection from the triatomine bug leading to dilated ventricles and $LV$ apical aneurysms.

Cocaine Abuse Cardiac Effect

Acute myocardial infarction is the most common associated cardiac complication.

Cushing Disease

High cortisol levels usually from a pituitary tumor, leading to left ventricular hypertrophy.

Diabetes Mellitus

A strong risk factor for coronary artery disease that also causes diastolic dysfunction and $LVH$.

Ehlers-Danlos Syndrome

A connective tissue disorder with elastic skin; echo shows aortic root dilatation and $Sinus of Valsalva$ aneurysm.

Fabry Disease

Inherited fat buildup causing a hyperechoic endocardial layer and symmetric or asymmetric hypertrophy.

Fen-Phen

An appetite suppressant linked to aortic and mitral valve thickening and pulmonary hypertension.

Friedreich Ataxia

A spinocerebellar degeneration disorder causing $LVH$ and reduced systolic function.

Gaucher Disease

A sphingolipid disorder associated with increased $LV$ mass and apical akinesis.

Holt Oram Syndrome

Also called Heart and Hand syndrome; causes skeletal abnormalities and septal defects ($ASD/VSD$).

Loeys-Dietz Syndrome

Also called Aortic Aneurysm Syndrome; an aggressive arterial aneurysm disorder with an average death age of $26$.

Noonan Syndrome

Autosomal dominant disorder causing pulmonic stenosis due to a dysplastic valve.

Osler-Weber-Rendu Disease

Vascular dysplasia leading to hemorrhages and pulmonary $AV$ malformations.

Pheochromocytoma

A benign adrenal tumor secreting catecholamines, causing systemic $HTN$ and $LVH$.

Pompe Disease

Glycogen accumulation in the myocardium causing global decrease in function and significant wall thickening.

Shone Complex

A combination of left ventricular inflow and outflow obstructions, such as a parachute mitral valve and coarctation.

Sickle Cell Disease

Abnormally shaped red blood cells leading to pulmonary hypertension and diastolic dysfunction.

Normal Blood Pressure

Systolic pressure $<120\,mmHg$ and diastolic pressure $<80\,mmHg$ consistently.

Stage 1 Hypertension

Systolic pressure $130-139\,mmHg$ or diastolic pressure $80-89\,mmHg$.

Stage 2 Hypertension

Systolic pressure $>140\,mmHg$ or diastolic pressure $>90\,mmHg$.

Malignant Hypertension

Critical hypertension with systolic pressure $>180\,mmHg$ and diastolic pressure $>120\,mmHg$.

Libman-Sacks Endocarditis

A cardiac manifestation of Systemic Lupus Erythematosus.

Turner Syndrome

Chromosomal disorder associated with aortic coarctation and bicuspid aortic valves.

Uhl Anomaly

Also called Parchment Heart; involves fatty replacement of the right ventricular free wall.

Myocarditis

Inflammation of the heart muscle, often associated with $AIDS$ or Lupus.

Eisenmenger Syndrome

A right-to-left shunt condition associated with cyanosis.

HOCM (Hypertrophic Obstructive Cardiomyopathy)

A condition that may require a stress echo to induce symptoms and visualize changes.

Pulmonary Hypertension SOB

Shortness of Breath ($SOB$) associated with elevated pressure in the lung arteries.

Mitral Stenosis Murmur Timing

An opening snap followed by a mid-diastolic murmur.

Mitral Valve Prolapse timing

Associated with a midsystolic click and late systolic murmur.

Dagger shaped waveform

The Doppler appearance of a systolic gradient in the $LV$ caused by left ventricular hypertrophy.